- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,029.09 / $1,661.62 / $6,634.04
| Facility | | $1,029.09 | $1,661.62 | $6,634.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,029.09 / $1,490.00 / $2,591.21
| Facility | | $1,029.09 | $1,490.00 | $2,591.21 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $280.43 / $298.00 / $518.24
| Facility | 80 | $280.43 | $298.00 | $518.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.00 / $4,086.00 / $7,778.00
| Facility | | $1,172.00 | $4,086.00 | $7,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $7,808.16 / $9,594.71
| Facility | | $55.00 | $7,808.16 | $9,594.71 |