- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.00 / $1,322.40 / $7,838.38
| Facility | | $1,047.00 | $1,322.40 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $315.57 / $315.57 / $315.57
| Facility | 54 | $315.57 | $315.57 | $315.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,546.18 / $5,354.03 / $8,308.17
| Facility | | $1,546.18 | $5,354.03 | $8,308.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $357.00 / $445.32 / $596.55
| Facility | | $357.00 | $445.32 | $596.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.00 / $3,503.00 / $6,999.76
| Facility | | $559.00 | $3,503.00 | $6,999.76 |