- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,141.21 / $9,062.00 / $18,276.00
| Facility | | $2,141.21 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,783.09 / $10,824.58 / $17,240.66
| Facility | | $4,783.09 | $10,824.58 | $17,240.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.00 / $890.00 / $2,125.46
| Facility | | $890.00 | $890.00 | $2,125.46 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $209.94 / $209.94 / $209.94
| Facility | AS | $209.94 | $209.94 | $209.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,092.48 / $2,569.46 / $4,145.35
| Facility | | $2,092.48 | $2,569.46 | $4,145.35 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $463.02 / $532.20 / $798.36
| Facility | 80 | $463.02 | $532.20 | $798.36 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $321.30 / $372.54 / $558.85
| Facility | AS | $321.30 | $372.54 | $558.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,303.00 / $15,713.00 / $23,485.00
| Facility | | $1,303.00 | $15,713.00 | $23,485.00 |