- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,201.58 / $1,615.00 / $6,953.60
| Facility | | $1,201.58 | $1,615.00 | $6,953.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $518.28 / $35,600.00
| Facility | | $0.71 | $518.28 | $35,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.67 / $1,441.91 / $2,217.23
| Facility | | $1,172.67 | $1,441.91 | $2,217.23 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $253.00 / $296.80 / $443.45
| Facility | 80 | $253.00 | $296.80 | $443.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.00 / $661.00 / $4,877.00
| Facility | | $301.00 | $661.00 | $4,877.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $9,160.56 / $11,085.20
| Facility | | $55.00 | $9,160.56 | $11,085.20 |