- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,649.36 / $8,263.84 / $16,467.00
| Facility | | $3,649.36 | $8,263.84 | $16,467.00 |
- 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
- $346.01 / $346.01 / $346.01
| Facility | AS | $346.01 | $346.01 | $346.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,120.00 / $3,726.73 / $6,239.04
| Facility | | $3,120.00 | $3,726.73 | $6,239.04 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $687.00 / $730.40 / $1,121.52
| Facility | 80 | $687.00 | $730.40 | $1,121.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $480.90 / $511.28 / $785.06
| Facility | AS | $480.90 | $511.28 | $785.06 |
- 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 |