- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,084.00 / $10,086.00 / $24,395.98
| Facility | | $2,084.00 | $10,086.00 | $24,395.98 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $7,734.66 / $7,734.66 / $7,734.66
| Facility | 80 | $7,734.66 | $7,734.66 | $7,734.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $2,851.07 / $3,394.13
| Facility | | $323.00 | $2,851.07 | $3,394.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.00 / $12,759.00 / $23,031.00
| Facility | | $5,979.00 | $12,759.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,072.00 / $12,923.00 / $19,866.00
| Facility | | $4,072.00 | $12,923.00 | $19,866.00 |