- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,612.00 / $8,400.00
| Facility | | $1,000.00 | $3,612.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $315.23 / $315.23 / $341.14
| Facility | 54 | $315.23 | $315.23 | $341.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.21 / $1,878.12 / $2,967.41
| Facility | | $1,182.21 | $1,878.12 | $2,967.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,351.42 / $1,351.42 / $1,351.42
| Facility | | $1,351.42 | $1,351.42 | $1,351.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.31 / $546.00 / $2,421.00
| Facility | | $420.31 | $546.00 | $2,421.00 |
- 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
- $375.00 / $1,265.00 / $2,637.00
| Facility | | $375.00 | $1,265.00 | $2,637.00 |