- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,530.64 / $5,643.01 / $8,977.00
| Facility | | $1,530.64 | $5,643.01 | $8,977.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,092.46 / $1,322.00 / $1,850.00
| Facility | | $1,092.46 | $1,322.00 | $1,850.00 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $212.07 / $276.54 / $362.60
| Facility | 80 | $212.07 | $276.54 | $362.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,928.90 / $12,081.00 / $19,066.00
| Facility | | $3,928.90 | $12,081.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,174.60 / $19,420.15 / $26,542.00
| Facility | | $6,174.60 | $19,420.15 | $26,542.00 |