- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,055.39 / $5,866.00 / $16,467.00
| Facility | | $1,055.39 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,324.25 / $8,231.14 / $15,308.76
| Facility | | $3,324.25 | $8,231.14 | $15,308.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $505.00 / $1,985.43
| Facility | | $505.00 | $505.00 | $1,985.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.00 / $890.00 / $1,471.27
| Facility | | $615.00 | $890.00 | $1,471.27 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $123.00 / $173.56 / $297.43
| Facility | 80 | $123.00 | $173.56 | $297.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $10,147.00 / $16,816.00
| Facility | | $1,981.00 | $10,147.00 | $16,816.00 |