- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,303.86 / $9,062.00 / $22,776.00
| Facility | | $2,303.86 | $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
- $216.98 / $216.98 / $216.98
| Facility | AS | $216.98 | $216.98 | $216.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,002.11 / $2,451.73 / $4,215.47
| Facility | | $2,002.11 | $2,451.73 | $4,215.47 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $480.40 / $490.35 / $792.33
| Facility | 80 | $480.40 | $490.35 | $792.33 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $336.28 / $343.24 / $554.63
| Facility | AS | $336.28 | $343.24 | $554.63 |
- 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 |