- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,117.42 / $10,666.52 / $21,886.00
| Facility | | $1,117.42 | $10,666.52 | $21,886.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,357.45 / $8,667.32 / $14,940.72
| Facility | | $3,357.45 | $8,667.32 | $14,940.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $894.30 / $1,229.16 / $2,027.68
| Facility | | $894.30 | $1,229.16 | $2,027.68 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $223.60 / $244.31 / $343.43
| Facility | 80 | $223.60 | $244.31 | $343.43 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $153.30 / $171.01 / $240.40
| Facility | AS | $153.30 | $171.01 | $240.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,959.00 / $23,485.00
| Facility | | $2,912.00 | $16,959.00 | $23,485.00 |