- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,394.59 / $5,427.35 / $16,467.00
| Facility | | $2,394.59 | $5,427.35 | $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
- $227.05 / $227.05 / $227.05
| Facility | AS | $227.05 | $227.05 | $227.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,716.00 / $2,340.09 / $4,070.80
| Facility | | $1,716.00 | $2,340.09 | $4,070.80 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $343.20 / $403.94 / $736.57
| Facility | 80 | $343.20 | $403.94 | $736.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $240.24 / $282.76 / $515.60
| Facility | AS | $240.24 | $282.76 | $515.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.00 / $6,074.00 / $8,818.00
| Facility | | $454.00 | $6,074.00 | $8,818.00 |