- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $964.76 / $7,799.00 / $17,247.00
| Facility | | $964.76 | $7,799.00 | $17,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,543.00 / $10,025.20 / $17,506.93
| Facility | | $3,543.00 | $10,025.20 | $17,506.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.00 / $2,831.77 / $3,638.88
| Facility | | $1,130.00 | $2,831.77 | $3,638.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.53 / $1,109.47 / $1,862.98
| Facility | | $826.53 | $1,109.47 | $1,862.98 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $193.40 / $228.39 / $312.08
| Facility | 80 | $193.40 | $228.39 | $312.08 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $135.38 / $159.87 / $218.45
| Facility | AS | $135.38 | $159.87 | $218.45 |
- 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 |