- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,813.50 / $12,443.20 / $29,697.48
| Facility | | $5,813.50 | $12,443.20 | $29,697.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,986.35 / $10,559.03 / $18,458.66
| Facility | | $3,986.35 | $10,559.03 | $18,458.66 |
- 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
- $924.72 / $1,322.63 / $2,139.02
| Facility | | $924.72 | $1,322.63 | $2,139.02 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $244.98 / $266.80 / $358.29
| Facility | 80 | $244.98 | $266.80 | $358.29 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $171.48 / $186.76 / $250.80
| Facility | AS | $171.48 | $186.76 | $250.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,766.00 / $20,341.00 / $27,446.00
| Facility | | $8,766.00 | $20,341.00 | $27,446.00 |