- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.99 / $4,771.00 / $10,767.00
| Facility | | $1,350.99 | $4,771.00 | $10,767.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,312.32 / $2,001.45 / $5,768.00
| Facility | | $1,312.32 | $2,001.45 | $5,768.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,136.73 / $1,364.08 / $1,682.36
| Professional | | $1,136.73 | $1,364.08 | $1,682.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,006.33 / $1,522.35 / $2,207.02
| Facility | | $1,006.33 | $1,522.35 | $2,207.02 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $198.34 / $214.00 / $475.71
| Facility | 80 | $198.34 | $214.00 | $475.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $138.84 / $149.80 / $333.00
| Facility | AS | $138.84 | $149.80 | $333.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.28 / $1,485.58 / $4,462.00
| Facility | | $763.28 | $1,485.58 | $4,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $3,130.00 / $5,226.00
| Facility | | $1,547.00 | $3,130.00 | $5,226.00 |