- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,731.13 / $5,412.00 / $13,209.00
| Facility | | $1,731.13 | $5,412.00 | $13,209.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,966.61 / $33,300.96 / $46,381.49
| Facility | | $14,966.61 | $33,300.96 | $46,381.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,385.47 / $1,662.56 / $2,050.50
| Professional | | $1,385.47 | $1,662.56 | $2,050.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,586.50 / $2,054.88 / $2,925.61
| Facility | | $1,586.50 | $2,054.88 | $2,925.61 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $470.19 / $530.35 / $610.45
| Facility | 80 | $470.19 | $530.35 | $610.45 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $329.13 / $371.24 / $427.31
| Facility | AS | $329.13 | $371.24 | $427.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,464.30 / $2,047.12 / $4,462.00
| Facility | | $1,464.30 | $2,047.12 | $4,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $3,130.00 / $5,226.00
| Facility | | $1,547.00 | $3,130.00 | $5,226.00 |