- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.00 / $1,411.87 / $3,363.00
| Facility | | $537.00 | $1,411.87 | $3,363.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $276.52 / $306.30 / $979.67
| Facility | 54 | $276.52 | $306.30 | $979.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.53 / $1,856.00 / $4,142.00
| Facility | | $706.53 | $1,856.00 | $4,142.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,508.05 / $1,508.05 / $1,508.05
| Facility | 54 | $1,508.05 | $1,508.05 | $1,508.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.91 / $648.80 / $1,158.26
| Facility | | $504.91 | $648.80 | $1,158.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.08 / $920.64 / $6,679.00
| Facility | | $422.08 | $920.64 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.98 / $586.98 / $1,859.98
| Facility | | $586.98 | $586.98 | $1,859.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $2,154.36 / $12,000.00
| Facility | | $627.00 | $2,154.36 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,508.05 / $1,508.05 / $1,508.05
| Facility | 54 | $1,508.05 | $1,508.05 | $1,508.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |