- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,102.97 / $9,062.00 / $24,566.31
| Facility | | $1,102.97 | $9,062.00 | $24,566.31 |
- 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
- $104.84 / $104.84 / $104.84
| Facility | AS | $104.84 | $104.84 | $104.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $958.00 / $1,118.10 / $1,884.52
| Facility | | $958.00 | $1,118.10 | $1,884.52 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $201.40 / $223.62 / $338.72
| Facility | 80 | $201.40 | $223.62 | $338.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $140.97 / $156.54 / $237.11
| Facility | AS | $140.97 | $156.54 | $237.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.00 / $6,074.00 / $8,818.00
| Facility | | $454.00 | $6,074.00 | $8,818.00 |