- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $9,772.37 / $17,782.79
| Facility | | $3,311.31 | $9,772.37 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $10,715.19 / $10,715.19 / $10,715.19
| Facility | 80 | $10,715.19 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $81,283.05 / $95,499.26
| Facility | | $46,773.51 | $81,283.05 | $95,499.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Facility | | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,258.93 / $1,479.11
| Facility | | $1,202.26 | $1,258.93 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,047.13 / $1,778.28
| Facility | | $724.44 | $1,047.13 | $1,778.28 |