- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.00 / $1,273.00 / $3,500.00
| Facility | | $497.00 | $1,273.00 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $373.29 / $386.23 / $651.76
| Facility | 54 | $373.29 | $386.23 | $651.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,343.06 / $2,728.26 / $4,087.58
| Facility | | $1,343.06 | $2,728.26 | $4,087.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $40.00 / $406.16
| Facility | | $40.00 | $40.00 | $406.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $425.00 / $425.00
| Facility | | $425.00 | $425.00 | $425.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $1,752.00 / $4,123.00
| Facility | | $500.00 | $1,752.00 | $4,123.00 |