- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.85 / $43.43 / $16,467.00
| Facility | | $21.85 | $43.43 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.26 / $25.13 / $37.95
| Facility | | $16.26 | $25.13 | $37.95 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $4.22 / $5.40 / $6.46
| Facility | 80 | $4.22 | $5.40 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2.94 / $3.78 / $4.51
| Facility | AS | $2.94 | $3.78 | $4.51 |
- 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 |