- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.12 / $396.96 / $903.00
| Facility | | $337.12 | $396.96 | $903.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $247.15 / $277.07 / $408.42
| Facility | 54 | $247.15 | $277.07 | $408.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.28 / $221.28 / $395.75
| Facility | | $221.28 | $221.28 | $395.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.06 / $443.30 / $750.13
| Facility | | $335.06 | $443.30 | $750.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.00 / $896.00 / $2,229.00
| Facility | | $117.00 | $896.00 | $2,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $907.36 / $1,806.66 / $12,000.00
| Facility | | $907.36 | $1,806.66 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $635.15 / $1,264.66 / $1,264.66
| Facility | 54 | $635.15 | $1,264.66 | $1,264.66 |