- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.86 / $500.13 / $7,212.00
| Facility | | $377.86 | $500.13 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $283.39 / $308.63 / $515.38
| Facility | 54 | $283.39 | $308.63 | $515.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,943.00 / $5,126.00 / $8,240.00
| Facility | | $1,943.00 | $5,126.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $396.21 / $522.07 / $783.11
| Facility | | $396.21 | $522.07 | $783.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.45 / $1,123.45 / $1,331.74
| Facility | | $1,123.45 | $1,123.45 | $1,331.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,341.25 / $2,804.00 / $4,078.00
| Facility | | $1,341.25 | $2,804.00 | $4,078.00 |