- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,035.74 / $18,276.00 / $39,677.33
| Facility | | $7,035.74 | $18,276.00 | $39,677.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $10,559.03 / $18,416.99
| Facility | | $5,000.00 | $10,559.03 | $18,416.99 |
- 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
- $1,221.07 / $1,643.10 / $2,825.47
| Facility | | $1,221.07 | $1,643.10 | $2,825.47 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $327.19 / $328.62 / $603.86
| Facility | 80 | $327.19 | $328.62 | $603.86 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $229.04 / $230.03 / $422.70
| Facility | AS | $229.04 | $230.03 | $422.70 |
- 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 |