- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.77 / $797.88 / $8,146.00
| Facility | | $292.77 | $797.88 | $8,146.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $206.66 / $224.04 / $245.74
| Facility | 54 | $206.66 | $224.04 | $245.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.73 / $128.77 / $323.00
| Facility | | $126.73 | $128.77 | $323.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,438.00 / $2,403.00 / $4,241.00
| Facility | | $1,438.00 | $2,403.00 | $4,241.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.00 / $1,950.00 / $5,107.00
| Facility | | $366.00 | $1,950.00 | $5,107.00 |