- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,821.00 / $11,269.00 / $30,459.98
| Facility | | $2,821.00 | $11,269.00 | $30,459.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,841.62 / $9,528.23 / $16,900.34
| Facility | | $3,841.62 | $9,528.23 | $16,900.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,024.22 / $1,322.00 / $2,322.03
| Facility | | $1,024.22 | $1,322.00 | $2,322.03 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $260.33 / $265.51 / $382.85
| Facility | 80 | $260.33 | $265.51 | $382.85 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $182.24 / $185.86 / $268.00
| Facility | AS | $182.24 | $185.86 | $268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,444.00 / $16,223.00 / $25,628.00
| Facility | | $9,444.00 | $16,223.00 | $25,628.00 |