- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $4,570.88 / $11,220.18
| Facility | | $954.99 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $331.13 / $10,000.00 / $10,000.00
| Facility | 80 | $331.13 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $8,912.51 / $17,782.79
| Facility | | $3,467.37 | $8,912.51 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,344.23 / $11,481.54
| Facility | | $1,023.29 | $2,344.23 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $114.82 / $114.82 / $114.82
| Facility | AS | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $8,317.64 / $17,782.79
| Facility | | $2,691.53 | $8,317.64 | $17,782.79 |