- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $1,520.00 / $3,685.00
| Facility | | $580.00 | $1,520.00 | $3,685.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $437.88 / $453.16 / $764.71
| Facility | 54 | $437.88 | $453.16 | $764.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,343.06 / $2,728.26 / $4,087.58
| Facility | | $1,343.06 | $2,728.26 | $4,087.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $40.00 / $465.01
| Facility | | $40.00 | $40.00 | $465.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $725.00 / $725.00 / $725.00
| Facility | | $725.00 | $725.00 | $725.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.00 / $1,429.00 / $4,123.00
| Facility | | $470.00 | $1,429.00 | $4,123.00 |