- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $542.04 / $611.17 / $4,933.00
| Facility | | $542.04 | $611.17 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $391.48 / $406.54 / $449.05
| Facility | 54 | $391.48 | $406.54 | $449.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,505.72 / $1,767.27 / $2,394.37
| Facility | | $1,505.72 | $1,767.27 | $2,394.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.91 / $1,314.15 / $6,147.03
| Facility | | $440.91 | $1,314.15 | $6,147.03 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $391.48 / $391.48 / $432.41
| Facility | 54 | $391.48 | $391.48 | $432.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $1,418.00 / $2,029.00
| Facility | | $300.00 | $1,418.00 | $2,029.00 |