- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,191.16 / $1,615.00 / $7,439.00
| Facility | | $1,191.16 | $1,615.00 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,136.00 / $1,458.23 / $2,978.91
| Facility | | $1,136.00 | $1,458.23 | $2,978.91 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $227.20 / $291.64 / $595.78
| Facility | 80 | $227.20 | $291.64 | $595.78 |
- 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 / $9,120.87 / $11,078.24
| Facility | | $55.00 | $9,120.87 | $11,078.24 |