- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,016.81 / $9,073.04 / $65,518.04
| Facility | | $2,016.81 | $9,073.04 | $65,518.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,852.87 / $16,155.56 / $28,242.50
| Facility | | $4,852.87 | $16,155.56 | $28,242.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,229.55 / $6,229.55 / $8,005.08
| Facility | | $6,229.55 | $6,229.55 | $8,005.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $893.19 / $1,215.93 / $1,776.03
| Facility | | $893.19 | $1,215.93 | $1,776.03 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $223.42 / $243.19 / $297.41
| Facility | 80 | $223.42 | $243.19 | $297.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $156.40 / $170.23 / $208.19
| Facility | AS | $156.40 | $170.23 | $208.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,877.00 / $17,186.00 / $24,729.00
| Facility | | $8,877.00 | $17,186.00 | $24,729.00 |