- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,594.43 / $9,300.29 / $21,932.74
| Facility | | $1,594.43 | $9,300.29 | $21,932.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,232.15 / $7,593.41 / $13,286.37
| Facility | | $3,232.15 | $7,593.41 | $13,286.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.00 / $2,831.77 / $3,638.88
| Facility | | $815.00 | $2,831.77 | $3,638.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.00 / $784.52 / $1,299.43
| Facility | | $504.00 | $784.52 | $1,299.43 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $100.80 / $166.88 / $220.38
| Facility | 80 | $100.80 | $166.88 | $220.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $70.56 / $116.82 / $154.27
| Facility | AS | $70.56 | $116.82 | $154.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |