- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.98 / $1,092.17 / $5,634.00
| Facility | | $382.98 | $1,092.17 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $287.24 / $318.73 / $532.42
| Facility | 54 | $287.24 | $318.73 | $532.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.00 / $3,840.00 / $7,747.00
| Facility | | $1,636.00 | $3,840.00 | $7,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.57 / $529.21 / $793.82
| Facility | | $385.57 | $529.21 | $793.82 |
- 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
- $933.00 / $2,252.00 / $4,426.00
| Facility | | $933.00 | $2,252.00 | $4,426.00 |