- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,431.94 / $9,062.00 / $18,276.00
| Facility | | $1,431.94 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,476.09 / $11,119.18 / $19,354.97
| Facility | | $5,476.09 | $11,119.18 | $19,354.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,403.28 / $5,740.31 / $14,963.00
| Facility | | $1,403.28 | $5,740.31 | $14,963.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $139.43 / $139.43 / $139.43
| Facility | AS | $139.43 | $139.43 | $139.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,317.46 / $1,575.13 / $2,717.80
| Facility | | $1,317.46 | $1,575.13 | $2,717.80 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $284.51 / $312.39 / $505.09
| Facility | 80 | $284.51 | $312.39 | $505.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $195.03 / $218.68 / $353.56
| Facility | AS | $195.03 | $218.68 | $353.56 |
- 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 |