- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,278.92 / $9,062.00 / $18,276.00
| Facility | | $1,278.92 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,511.30 / $11,396.22 / $19,507.71
| Facility | | $5,511.30 | $11,396.22 | $19,507.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.63 / $10,619.00 / $14,963.00
| Facility | | $1,240.63 | $10,619.00 | $14,963.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $123.07 / $123.07 / $123.07
| Facility | AS | $123.07 | $123.07 | $123.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,136.39 / $1,359.88 / $2,414.31
| Facility | | $1,136.39 | $1,359.88 | $2,414.31 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $248.40 / $269.39 / $457.71
| Facility | 80 | $248.40 | $269.39 | $457.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $173.23 / $188.58 / $320.39
| Facility | AS | $173.23 | $188.58 | $320.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $17,146.00 / $24,161.00
| Facility | | $3,028.00 | $17,146.00 | $24,161.00 |