- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,448.57 / $12,691.35 / $36,554.91
| Facility | | $2,448.57 | $12,691.35 | $36,554.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,242.75 / $10,380.37 / $18,658.80
| Facility | | $4,242.75 | $10,380.37 | $18,658.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,639.40 / $3,639.40 / $4,676.68
| Facility | | $3,639.40 | $3,639.40 | $4,676.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.49 / $1,237.00 / $2,018.52
| Facility | | $891.49 | $1,237.00 | $2,018.52 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $237.76 / $247.40 / $332.31
| Facility | 80 | $237.76 | $247.40 | $332.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $166.43 / $173.18 / $232.61
| Facility | AS | $166.43 | $173.18 | $232.61 |
- 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 |