- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $359.94 / $2,815.00 / $10,086.00
| Facility | | $359.94 | $2,815.00 | $10,086.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $246.11 / $262.27 / $289.60
| Facility | 54 | $246.11 | $262.27 | $289.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $835.58 / $994.74
| Facility | | $323.00 | $835.58 | $994.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,578.00 / $4,823.00 / $9,635.00
| Facility | | $2,578.00 | $4,823.00 | $9,635.00 |
- 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 |