- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $808.36 / $2,233.10 / $8,177.32
| Facility | | $808.36 | $2,233.10 | $8,177.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,221.47 / $3,221.47 / $4,603.08
| Facility | | $3,221.47 | $3,221.47 | $4,603.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $7,698.56
| Facility | | $606.10 | $606.10 | $7,698.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $807.61 / $980.08 / $1,494.04
| Facility | | $807.61 | $980.08 | $1,494.04 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $156.05 / $228.20 / $365.38
| Facility | 80 | $156.05 | $228.20 | $365.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $109.24 / $152.87 / $255.77
| Facility | AS | $109.24 | $152.87 | $255.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,095.08 / $25,442.40 / $26,542.00
| Facility | | $3,095.08 | $25,442.40 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $191.01 / $1,449.86 / $2,411.58
| Facility | AS | $191.01 | $1,449.86 | $2,411.58 |