- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $449.95 / $1,386.00 / $7,212.00
| Facility | | $449.95 | $1,386.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $337.46 / $337.46 / $557.27
| Facility | 54 | $337.46 | $337.46 | $557.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,943.00 / $5,126.00 / $8,240.00
| Facility | | $1,943.00 | $5,126.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.45 / $615.52 / $923.28
| Facility | | $448.45 | $615.52 | $923.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.45 / $1,123.45 / $1,331.74
| Facility | | $1,123.45 | $1,123.45 | $1,331.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $3,874.00 / $5,490.00
| Facility | | $2,400.00 | $3,874.00 | $5,490.00 |