- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,371.68 / $1,615.00 / $6,953.60
| Facility | | $1,371.68 | $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
- $1,302.40 / $1,646.02 / $2,552.11
| Facility | | $1,302.40 | $1,646.02 | $2,552.11 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $260.48 / $325.00 / $510.42
| Facility | 80 | $260.48 | $325.00 | $510.42 |
- 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 / $10,332.95 / $12,535.60
| Facility | | $55.00 | $10,332.95 | $12,535.60 |