- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.04 / $6,230.78 / $15,141.79
| Facility | | $1,248.04 | $6,230.78 | $15,141.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $7,363.00 / $9,410.00
| Facility | | $6,153.00 | $7,363.00 | $9,410.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $878.54 / $1,054.25 / $1,300.24
| Professional | | $878.54 | $1,054.25 | $1,300.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $872.67 / $1,228.16 / $1,748.58
| Facility | | $872.67 | $1,228.16 | $1,748.58 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $235.32 / $331.88 / $367.67
| Facility | 80 | $235.32 | $331.88 | $367.67 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $164.72 / $232.32 / $257.37
| Facility | AS | $164.72 | $232.32 | $257.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.10 / $1,216.65 / $5,122.00
| Facility | | $924.10 | $1,216.65 | $5,122.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,373.00 / $17,192.00
| Facility | | $6,303.00 | $9,373.00 | $17,192.00 |