- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,371.24 / $10,395.00 / $29,698.77
| Facility | | $1,371.24 | $10,395.00 | $29,698.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,498.57 / $10,559.03 / $18,458.66
| Facility | | $3,498.57 | $10,559.03 | $18,458.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,639.40 / $3,639.40 / $4,676.68
| Facility | | $3,639.40 | $3,639.40 | $4,676.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.14 / $681.23 / $1,155.59
| Facility | | $501.14 | $681.23 | $1,155.59 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $118.00 / $138.66 / $216.00
| Facility | 80 | $118.00 | $138.66 | $216.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $82.60 / $95.37 / $151.19
| Facility | AS | $82.60 | $95.37 | $151.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,627.00 / $25,620.00
| Facility | | $3,028.00 | $19,627.00 | $25,620.00 |