- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,059.83 / $10,868.00 / $36,443.97
| Facility | | $1,059.83 | $10,868.00 | $36,443.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,839.33 / $10,000.70 / $10,938.56
| Facility | | $8,839.33 | $10,000.70 | $10,938.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $903.17 / $1,270.00 / $2,088.69
| Facility | | $903.17 | $1,270.00 | $2,088.69 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $233.60 / $254.00 / $356.52
| Facility | 80 | $233.60 | $254.00 | $356.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |