- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,317.46 / $7,799.00 / $24,649.00
| Facility | | $2,317.46 | $7,799.00 | $24,649.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,234.37 / $17,704.41 / $28,307.41
| Facility | | $9,234.37 | $17,704.41 | $28,307.41 |
- 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
- $218.55 / $218.55 / $218.55
| Facility | AS | $218.55 | $218.55 | $218.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,969.84 / $2,428.00 / $3,957.11
| Facility | | $1,969.84 | $2,428.00 | $3,957.11 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $445.40 / $485.60 / $726.43
| Facility | 80 | $445.40 | $485.60 | $726.43 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $311.77 / $339.92 / $508.50
| Facility | AS | $311.77 | $339.92 | $508.50 |
- 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 |