- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.98 / $14,691.00 / $22,275.75
| Facility | | $1,682.98 | $14,691.00 | $22,275.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,132.63 / $10,755.54 / $18,562.29
| Facility | | $4,132.63 | $10,755.54 | $18,562.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,229.55 / $6,229.55 / $8,005.08
| Facility | | $6,229.55 | $6,229.55 | $8,005.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.18 / $1,852.46 / $3,064.02
| Facility | | $1,350.18 | $1,852.46 | $3,064.02 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $342.80 / $367.07 / $518.03
| Facility | 80 | $342.80 | $367.07 | $518.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,627.00 / $25,620.00
| Facility | | $3,028.00 | $19,627.00 | $25,620.00 |