- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.34 / $2,783.06 / $22,997.00
| Facility | | $1,775.34 | $2,783.06 | $22,997.00 |
- 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
- $200.73 / $200.73 / $200.73
| Facility | AS | $200.73 | $200.73 | $200.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.35 / $2,217.40 / $3,229.13
| Facility | | $1,775.35 | $2,217.40 | $3,229.13 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $411.60 / $453.16 / $665.31
| Facility | 80 | $411.60 | $453.16 | $665.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $287.43 / $313.32 / $465.72
| Facility | AS | $287.43 | $313.32 | $465.72 |
- 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
- $10,160.00 / $13,325.92 / $16,242.56
| Facility | | $10,160.00 | $13,325.92 | $16,242.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $402.33 / $868.18 / $868.18
| Facility | AS | $402.33 | $868.18 | $868.18 |