- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,192.78 / $1,927.18 / $10,924.00
| Facility | | $1,192.78 | $1,927.18 | $10,924.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $518.28 / $35,600.00
| Facility | | $0.71 | $518.28 | $35,600.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $135.26 / $135.26 / $135.26
| Facility | AS | $135.26 | $135.26 | $135.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,192.78 / $1,492.27 / $2,146.96
| Facility | | $1,192.78 | $1,492.27 | $2,146.96 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $291.99 / $329.83 / $445.32
| Facility | 80 | $291.99 | $329.83 | $445.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $193.01 / $230.88 / $303.60
| Facility | AS | $193.01 | $230.88 | $303.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.00 / $661.00 / $4,877.00
| Facility | | $301.00 | $661.00 | $4,877.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $8,971.52 / $10,932.32
| Facility | | $2,800.00 | $8,971.52 | $10,932.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $268.41 / $590.26 / $590.26
| Facility | AS | $268.41 | $590.26 | $590.26 |