- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.15 / $411.07 / $16,467.00
| Facility | | $205.15 | $411.07 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.61 / $241.41 / $356.81
| Facility | | $159.61 | $241.41 | $356.81 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $40.97 / $52.80 / $60.73
| Facility | 80 | $40.97 | $52.80 | $60.73 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $27.84 / $36.96 / $42.51
| Facility | AS | $27.84 | $36.96 | $42.51 |
- 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 |