- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $3,051.36 / $6,953.60
| Facility | | $1,615.00 | $3,051.36 | $6,953.60 |
- 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
- $346.01 / $346.01 / $346.01
| Facility | AS | $346.01 | $346.01 | $346.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,051.36 / $3,726.73 / $5,607.60
| Facility | | $3,051.36 | $3,726.73 | $5,607.60 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $687.00 / $762.93 / $1,124.63
| Facility | 80 | $687.00 | $762.93 | $1,124.63 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $480.90 / $511.28 / $768.74
| Facility | AS | $480.90 | $511.28 | $768.74 |
- 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
- $55.00 / $25,894.53 / $31,253.49
| Facility | | $55.00 | $25,894.53 | $31,253.49 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $680.49 / $1,481.13 / $1,481.13
| Facility | AS | $680.49 | $1,481.13 | $1,481.13 |