- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.82 / $4,375.00 / $16,467.00
| Facility | | $436.82 | $4,375.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.93 / $438.00 / $716.67
| Facility | | $331.93 | $438.00 | $716.67 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $84.40 / $85.46 / $129.02
| Facility | 80 | $84.40 | $85.46 | $129.02 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $50.21 / $59.82 / $82.62
| Facility | AS | $50.21 | $59.82 | $82.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,107.00 / $8,818.00
| Facility | | $659.00 | $6,107.00 | $8,818.00 |