- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.56 / $2,946.27 / $10,632.00
| Facility | | $350.56 | $2,946.27 | $10,632.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $242.95 / $260.33 / $281.45
| Facility | 54 | $242.95 | $260.33 | $281.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.00 / $835.58 / $994.74
| Facility | | $432.00 | $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
- $591.00 / $2,671.00 / $6,077.00
| Facility | | $591.00 | $2,671.00 | $6,077.00 |