- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.34 / $274.76 / $7,439.00
| Facility | | $176.34 | $274.76 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.34 / $255.53 / $378.07
| Facility | | $176.34 | $255.53 | $378.07 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $46.29 / $55.05 / $86.81
| Facility | 80 | $46.29 | $55.05 | $86.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,064.00 / $3,906.00 / $6,388.00
| Facility | | $1,064.00 | $3,906.00 | $6,388.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $436.20 / $845.17
| Facility | | $55.00 | $436.20 | $845.17 |