- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,641.51 / $3,756.62 / $16,467.00
| Facility | | $1,641.51 | $3,756.62 | $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
- $1,272.00 / $1,641.51 / $2,812.26
| Facility | | $1,272.00 | $1,641.51 | $2,812.26 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $254.40 / $325.00 / $509.83
| Facility | 80 | $254.40 | $325.00 | $509.83 |
- 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 |