- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.16 / $581.87 / $16,467.00
| Facility | | $262.16 | $581.87 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.44 / $281.80 / $479.67
| Facility | | $217.44 | $281.80 | $479.67 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $53.83 / $55.50 / $78.97
| Facility | 80 | $53.83 | $55.50 | $78.97 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $37.68 / $38.51 / $55.28
| Facility | AS | $37.68 | $38.51 | $55.28 |
- 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 |