- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.23 / $2,324.00 / $10,632.00
| Facility | | $362.23 | $2,324.00 | $10,632.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $228.08 / $265.41 / $271.67
| Facility | 54 | $228.08 | $265.41 | $271.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $835.58 / $994.74
| Facility | | $323.00 | $835.58 | $994.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,578.00 / $4,823.00 / $9,635.00
| Facility | | $2,578.00 | $4,823.00 | $9,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.00 / $3,611.00 / $8,105.00
| Facility | | $1,014.00 | $3,611.00 | $8,105.00 |