- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.22 / $9,062.00 / $18,276.00
| Facility | | $1,480.22 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,073.24 / $5,808.35 / $9,670.36
| Facility | | $3,073.24 | $5,808.35 | $9,670.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $715.00 / $1,985.43
| Facility | | $715.00 | $715.00 | $1,985.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,135.00 / $1,517.31 / $2,085.77
| Facility | | $1,135.00 | $1,517.31 | $2,085.77 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $227.00 / $301.60 / $417.15
| Facility | 80 | $227.00 | $301.60 | $417.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $10,257.00 / $16,249.00
| Facility | | $1,258.00 | $10,257.00 | $16,249.00 |