- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.18 / $11,124.00 / $34,398.11
| Facility | | $1,350.18 | $11,124.00 | $34,398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.18 / $1,883.20 / $3,412.76
| Facility | | $1,350.18 | $1,883.20 | $3,412.76 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $339.40 / $376.64 / $682.55
| Facility | 80 | $339.40 | $376.64 | $682.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,688.00 / $15,545.00 / $22,780.00
| Facility | | $6,688.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,863.68 / $26,542.00 / $27,770.10
| Facility | | $8,863.68 | $26,542.00 | $27,770.10 |