- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,624.93 / $31,680.82 / $43,788.12
| Facility | | $4,624.93 | $31,680.82 | $43,788.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.20 / $194.20 / $194.20
| Facility | AS | $194.20 | $194.20 | $194.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.72 / $2,149.06 / $3,831.16
| Facility | | $1,737.72 | $2,149.06 | $3,831.16 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $417.14 / $429.81 / $704.75
| Facility | 80 | $417.14 | $429.81 | $704.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $292.00 / $300.87 / $489.47
| Facility | AS | $292.00 | $300.87 | $489.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,098.00 / $15,713.00 / $23,583.00
| Facility | | $2,098.00 | $15,713.00 | $23,583.00 |