- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.03 / $1,188.00 / $10,337.08
| Facility | | $470.03 | $1,188.00 | $10,337.08 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $352.52 / $352.52 / $545.32
| Facility | 54 | $352.52 | $352.52 | $545.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,438.74
| Facility | | $530.04 | $530.04 | $1,438.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.03 / $604.83 / $928.11
| Facility | | $470.03 | $604.83 | $928.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,816.20 / $4,754.80 / $16,394.00
| Facility | | $1,816.20 | $4,754.80 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $778.37 / $1,896.69 / $3,154.80
| Facility | 54 | $778.37 | $1,896.69 | $3,154.80 |