- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,704.32 / $3,868.48 / $16,467.00
| Facility | | $1,704.32 | $3,868.48 | $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
- $1,448.67 / $1,742.77 / $2,897.34
| Facility | | $1,448.67 | $1,742.77 | $2,897.34 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $316.80 / $348.29 / $525.01
| Facility | 80 | $316.80 | $348.29 | $525.01 |
- 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 |