- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.38 / $9,062.00 / $22,776.00
| Facility | | $1,949.38 | $9,062.00 | $22,776.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,209.42 / $9,209.42 / $9,209.42
| Facility | | $9,209.42 | $9,209.42 | $9,209.42 |
- 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
- $184.06 / $184.06 / $184.06
| Facility | AS | $184.06 | $184.06 | $184.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.05 / $2,062.61 / $3,321.91
| Facility | | $1,671.05 | $2,062.61 | $3,321.91 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $403.30 / $412.52 / $606.20
| Facility | 80 | $403.30 | $412.52 | $606.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $282.31 / $288.77 / $424.34
| Facility | AS | $282.31 | $288.77 | $424.34 |
- 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 |