- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,057.84 / $5,676.52 / $16,046.00
| Facility | | $1,057.84 | $5,676.52 | $16,046.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,137.07 / $1,918.03 / $13,714.86
| Facility | | $1,137.07 | $1,918.03 | $13,714.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.97 / $4,581.64 / $8,000.00
| Facility | | $1,061.97 | $4,581.64 | $8,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $979.33 / $979.33 / $1,026.79
| Facility | | $979.33 | $979.33 | $1,026.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $11,682.00 / $15,735.00
| Facility | | $900.00 | $11,682.00 | $15,735.00 |
- 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
- $55.00 / $15,184.32 / $22,630.00
| Facility | | $55.00 | $15,184.32 | $22,630.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $245.18 / $502.13 / $521.04
| Facility | AS | $245.18 | $502.13 | $521.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.29 / $1,362.86 / $2,472.41
| Facility | | $1,047.29 | $1,362.86 | $2,472.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.29 / $1,378.78 / $2,530.71
| Facility | | $1,047.29 | $1,378.78 | $2,530.71 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $424.37 / $424.37 / $424.37
| Facility | 80 | $424.37 | $424.37 | $424.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $123.14 / $360.71 / $360.71
| Facility | AS | $123.14 | $360.71 | $360.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $8,142.00 / $18,555.00
| Facility | | $2,600.00 | $8,142.00 | $18,555.00 |