- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.68 / $1,408.34 / $16,467.00
| Facility | | $711.68 | $1,408.34 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.02 / $697.87 / $1,231.09
| Facility | | $485.02 | $697.87 | $1,231.09 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $100.00 / $135.96 / $209.50
| Facility | 80 | $100.00 | $135.96 | $209.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $70.00 / $81.89 / $146.65
| Facility | AS | $70.00 | $81.89 | $146.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,107.00 / $8,818.00
| Facility | | $659.00 | $6,107.00 | $8,818.00 |