- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.82 / $9,062.00 / $18,276.00
| Facility | | $1,862.82 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,415.51 / $1,876.64 / $3,083.62
| Facility | | $1,415.51 | $1,876.64 | $3,083.62 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $359.88 / $365.86 / $552.91
| Facility | 80 | $359.88 | $365.86 | $552.91 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $214.32 / $256.10 / $353.40
| Facility | AS | $214.32 | $256.10 | $353.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,284.00 / $6,074.00 / $8,973.00
| Facility | | $2,284.00 | $6,074.00 | $8,973.00 |