- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.51 / $3,232.00 / $10,439.00
| Facility | | $548.51 | $3,232.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $374.26 / $414.61 / $541.36
| Facility | 54 | $374.26 | $414.61 | $541.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $757.15 / $1,114.26 / $1,767.27
| Facility | | $757.15 | $1,114.26 | $1,767.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.00 / $330.00 / $330.00
| Facility | | $330.00 | $330.00 | $330.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.48 / $577.45 / $1,247.94
| Facility | | $406.48 | $577.45 | $1,247.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.00 / $550.00 / $1,769.00
| Facility | | $191.00 | $550.00 | $1,769.00 |