- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.34 / $3,268.33 / $16,467.00
| Facility | | $1,445.34 | $3,268.33 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,201.58 / $1,462.28 / $2,462.14
| Facility | | $1,201.58 | $1,462.28 | $2,462.14 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $253.00 / $273.39 / $443.56
| Facility | 80 | $253.00 | $273.39 | $443.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.00 / $6,074.00 / $8,818.00
| Facility | | $454.00 | $6,074.00 | $8,818.00 |