- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,335.46 / $6,953.60 / $12,075.10
| Facility | | $1,335.46 | $6,953.60 | $12,075.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,807.46 / $6,807.46 / $6,906.79
| Facility | | $6,807.46 | $6,807.46 | $6,906.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $13,652.00
| Facility | | $606.10 | $606.10 | $13,652.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,335.46 / $1,816.79 / $2,647.60
| Facility | | $1,335.46 | $1,816.79 | $2,647.60 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $331.64 / $400.40 / $603.63
| Facility | 80 | $331.64 | $400.40 | $603.63 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $232.15 / $280.27 / $422.54
| Facility | AS | $232.15 | $280.27 | $422.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $14,017.86 / $14,017.86
| Facility | | $5,000.00 | $14,017.86 | $14,017.86 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $191.07 / $335.89 / $672.91
| Facility | AS | $191.07 | $335.89 | $672.91 |