- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,304.67 / $8,895.74 / $36,788.00
| Facility | | $1,304.67 | $8,895.74 | $36,788.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,285.60 / $10,248.92 / $10,985.72
| Facility | | $6,285.60 | $10,248.92 | $10,985.72 |
- 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
- $123.14 / $123.14 / $123.14
| Facility | AS | $123.14 | $123.14 | $123.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.77 / $1,638.63 / $2,254.67
| Facility | | $1,152.77 | $1,638.63 | $2,254.67 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $327.73 / $327.73 / $404.70
| Facility | 80 | $327.73 | $327.73 | $404.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $223.65 / $229.41 / $283.29
| Facility | AS | $223.65 | $229.41 | $283.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,250.00 / $16,269.00 / $24,161.00
| Facility | | $1,250.00 | $16,269.00 | $24,161.00 |