- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,294.57 / $7,439.00
| Facility | | $1,615.00 | $2,294.57 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,135.01 / $3,506.86 / $5,263.87
| Facility | | $2,135.01 | $3,506.86 | $5,263.87 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $404.71 / $794.00 / $1,052.77
| Facility | 80 | $404.71 | $794.00 | $1,052.77 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $344.00 / $555.79 / $736.94
| Facility | AS | $344.00 | $555.79 | $736.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.00 / $4,086.00 / $7,778.00
| Facility | | $1,172.00 | $4,086.00 | $7,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $38,207.10 / $46,078.80
| Facility | | $55.00 | $38,207.10 | $46,078.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $481.91 / $528.72 / $1,025.43
| Facility | AS | $481.91 | $528.72 | $1,025.43 |