- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.83 / $4,884.27 / $8,031.00
| Facility | | $636.83 | $4,884.27 | $8,031.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $444.11 / $477.62 / $630.58
| Facility | 54 | $444.11 | $477.62 | $630.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,410.00 / $7,483.00 / $15,501.00
| Facility | | $5,410.00 | $7,483.00 | $15,501.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $737.00 / $2,296.86 / $2,296.86
| Facility | | $737.00 | $2,296.86 | $2,296.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,340.80 / $1,643.00 / $1,677.00
| Facility | | $1,340.80 | $1,643.00 | $1,677.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.00 / $4,210.00 / $7,760.00
| Facility | | $1,157.00 | $4,210.00 | $7,760.00 |