- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.96 / $2,071.08 / $6,246.00
| Facility | | $511.96 | $2,071.08 | $6,246.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $313.12 / $325.76 / $483.77
| Facility | 54 | $313.12 | $325.76 | $483.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,723.00 / $3,693.00 / $5,962.00
| Facility | | $1,723.00 | $3,693.00 | $5,962.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.05 / $835.58 / $1,153.31
| Facility | | $472.05 | $835.58 | $1,153.31 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $328.83 / $328.83 / $328.83
| Facility | 54 | $328.83 | $328.83 | $328.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.00 / $3,105.02 / $5,490.00
| Facility | | $1,380.00 | $3,105.02 | $5,490.00 |