- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $4,677.35 / $11,481.54
| Facility | | $1,737.80 | $4,677.35 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $1,096.48 / $1,096.48 / $1,096.48
| Facility | 80 | $1,096.48 | $1,096.48 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,882.50 / $28,840.32
| Facility | | $4,365.16 | $12,882.50 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $4,570.88 / $11,748.98
| Facility | | $398.11 | $4,570.88 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | 62 | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,162.28 / $10,232.93
| Facility | | $851.14 | $3,162.28 | $10,232.93 |