- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.62 / $4,228.00 / $8,031.00
| Facility | | $541.62 | $4,228.00 | $8,031.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $371.49 / $406.22 / $1,180.29
| Facility | 54 | $371.49 | $406.22 | $1,180.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,410.00 / $7,483.00 / $20,032.00
| Facility | | $5,410.00 | $7,483.00 | $20,032.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.26 / $353.26 / $550.00
| Facility | | $353.26 | $353.26 | $550.00 |
- 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
- $1,380.00 / $3,075.00 / $6,664.00
| Facility | | $1,380.00 | $3,075.00 | $6,664.00 |