- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,428.85 / $9,062.00 / $22,776.00
| Facility | | $1,428.85 | $9,062.00 | $22,776.00 |
- 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
- $135.26 / $135.26 / $135.26
| Facility | AS | $135.26 | $135.26 | $135.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,227.05 / $1,492.27 / $2,440.71
| Facility | | $1,227.05 | $1,492.27 | $2,440.71 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $290.25 / $298.45 / $446.33
| Facility | 80 | $290.25 | $298.45 | $446.33 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $203.17 / $208.92 / $312.43
| Facility | AS | $203.17 | $208.92 | $312.43 |
- 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 |