- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.48 / $6,705.00 / $14,867.45
| Facility | | $1,548.48 | $6,705.00 | $14,867.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,671.00 / $14,927.78 / $20,791.37
| Facility | | $8,671.00 | $14,927.78 | $20,791.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,287.53 / $1,545.04 / $1,905.54
| Professional | | $1,287.53 | $1,545.04 | $1,905.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,542.73 / $2,013.02 / $3,012.56
| Facility | | $1,542.73 | $2,013.02 | $3,012.56 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $448.59 / $550.00 / $1,112.20
| Facility | 80 | $448.59 | $550.00 | $1,112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,487.90 / $2,020.26 / $3,658.00
| Facility | | $1,487.90 | $2,020.26 | $3,658.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $3,130.00 / $5,226.00
| Facility | | $1,547.00 | $3,130.00 | $5,226.00 |