- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.91 / $3,213.00 / $7,365.00
| Facility | | $485.91 | $3,213.00 | $7,365.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $257.66 / $280.36 / $364.44
| Facility | 54 | $257.66 | $280.36 | $364.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $821.00 / $1,963.00 / $4,852.00
| Facility | | $821.00 | $1,963.00 | $4,852.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.81 / $607.38 / $2,020.00
| Facility | | $373.81 | $607.38 | $2,020.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,330.94 / $1,330.94 / $1,330.94
| Facility | 54 | $1,330.94 | $1,330.94 | $1,330.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $1,291.00 / $2,539.00
| Facility | | $1,106.00 | $1,291.00 | $2,539.00 |