- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,262.17 / $5,131.34 / $16,467.00
| Facility | | $2,262.17 | $5,131.34 | $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
- $1,667.00 / $2,227.32 / $3,845.71
| Facility | | $1,667.00 | $2,227.32 | $3,845.71 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $324.00 / $384.20 / $696.40
| Facility | 80 | $324.00 | $384.20 | $696.40 |
- 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 |