- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,242.25 / $2,833.63 / $16,467.00
| Facility | | $1,242.25 | $2,833.63 | $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
- $117.55 / $117.55 / $117.55
| Facility | AS | $117.55 | $117.55 | $117.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,055.91 / $1,302.46 / $2,111.83
| Facility | | $1,055.91 | $1,302.46 | $2,111.83 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $243.20 / $260.49 / $384.56
| Facility | 80 | $243.20 | $260.49 | $384.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $170.24 / $182.34 / $269.19
| Facility | AS | $170.24 | $182.34 | $269.19 |
- 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 |