- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,191.20 / $12,487.35 / $18,677.66
| Facility | | $1,191.20 | $12,487.35 | $18,677.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,184.70 / $9,206.45 / $15,602.02
| Facility | | $4,184.70 | $9,206.45 | $15,602.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.00 / $1,130.00 / $3,424.28
| Facility | | $1,130.00 | $1,130.00 | $3,424.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.19 / $1,334.00 / $2,283.98
| Facility | | $973.19 | $1,334.00 | $2,283.98 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $204.40 / $270.73 / $480.40
| Facility | 80 | $204.40 | $270.73 | $480.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,666.00 / $16,223.00 / $23,485.00
| Facility | | $2,666.00 | $16,223.00 | $23,485.00 |