- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,347.78 / $3,097.11 / $16,467.00
| Facility | | $1,347.78 | $3,097.11 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $128.13 / $128.13 / $128.13
| Facility | AS | $128.13 | $128.13 | $128.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,173.82 / $1,528.13 / $2,317.73
| Facility | | $1,173.82 | $1,528.13 | $2,317.73 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $305.63 / $305.63 / $420.32
| Facility | 80 | $305.63 | $305.63 | $420.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $213.94 / $213.94 / $294.23
| Facility | AS | $213.94 | $213.94 | $294.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.00 / $5,871.00 / $8,973.00
| Facility | | $600.00 | $5,871.00 | $8,973.00 |