- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,323.95 / $13,657.33 / $29,698.78
| Facility | | $4,323.95 | $13,657.33 | $29,698.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,114.38 / $10,097.87 / $18,142.18
| Facility | | $4,114.38 | $10,097.87 | $18,142.18 |
- 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
- $951.37 / $1,283.31 / $2,085.19
| Facility | | $951.37 | $1,283.31 | $2,085.19 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $244.49 / $256.66 / $450.84
| Facility | 80 | $244.49 | $256.66 | $450.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $171.15 / $179.66 / $315.58
| Facility | AS | $171.15 | $179.66 | $315.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,627.00 / $25,620.00
| Facility | | $3,028.00 | $19,627.00 | $25,620.00 |