- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $276.38 / $11,633.00 / $17,247.00
| Facility | | $276.38 | $11,633.00 | $17,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,111.52 / $7,593.41 / $13,640.30
| Facility | | $3,111.52 | $7,593.41 | $13,640.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.73 / $360.50 / $552.86
| Facility | | $246.73 | $360.50 | $552.86 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $66.53 / $78.45 / $101.64
| Facility | 80 | $66.53 | $78.45 | $101.64 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $46.57 / $54.92 / $71.15
| Facility | AS | $46.57 | $54.92 | $71.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $1,221.00 / $3,585.00
| Facility | | $225.00 | $1,221.00 | $3,585.00 |