- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,411.93 / $3,218.52 / $16,467.00
| Facility | | $1,411.93 | $3,218.52 | $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
- $134.03 / $134.03 / $134.03
| Facility | AS | $134.03 | $134.03 | $134.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,168.00 / $1,437.59 / $2,415.71
| Facility | | $1,168.00 | $1,437.59 | $2,415.71 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $224.21 / $287.52 / $436.80
| Facility | 80 | $224.21 | $287.52 | $436.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $156.94 / $201.26 / $305.76
| Facility | AS | $156.94 | $201.26 | $305.76 |
- 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 |