- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,891.13 / $9,062.00 / $18,276.00
| Facility | | $1,891.13 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,476.09 / $11,396.22 / $19,507.71
| Facility | | $5,476.09 | $11,396.22 | $19,507.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,858.07 / $2,345.00 / $5,740.31
| Facility | | $1,858.07 | $2,345.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $184.10 / $184.10 / $184.10
| Facility | AS | $184.10 | $184.10 | $184.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,758.73 / $2,121.00 / $3,621.47
| Facility | | $1,758.73 | $2,121.00 | $3,621.47 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $381.32 / $424.20 / $676.18
| Facility | 80 | $381.32 | $424.20 | $676.18 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $256.14 / $296.94 / $473.32
| Facility | AS | $256.14 | $296.94 | $473.32 |
- 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 |