- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $835.50 / $8,324.39 / $18,276.00
| Facility | | $835.50 | $8,324.39 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,127.37 / $10,229.31 / $20,652.61
| Facility | | $3,127.37 | $10,229.31 | $20,652.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $823.12 / $16,113.79
| Facility | | $715.00 | $823.12 | $16,113.79 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $81.76 / $81.76 / $81.76
| Facility | AS | $81.76 | $81.76 | $81.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $819.51 / $1,074.00 / $1,612.85
| Facility | | $819.51 | $1,074.00 | $1,612.85 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $189.47 / $227.20 / $311.31
| Facility | 80 | $189.47 | $227.20 | $311.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $116.48 / $159.04 / $217.91
| Facility | AS | $116.48 | $159.04 | $217.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |