- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,087.02 / $9,062.00 / $18,276.00
| Facility | | $1,087.02 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,939.32 / $9,602.04 / $16,900.34
| Facility | | $3,939.32 | $9,602.04 | $16,900.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,019.05 / $1,313.00 / $2,302.96
| Facility | | $1,019.05 | $1,313.00 | $2,302.96 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $252.95 / $264.00 / $378.78
| Facility | 80 | $252.95 | $264.00 | $378.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,959.00 / $23,485.00
| Facility | | $2,912.00 | $16,959.00 | $23,485.00 |