- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.75 / $2,507.00 / $7,365.00
| Facility | | $504.75 | $2,507.00 | $7,365.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $261.17 / $289.49 / $368.48
| Facility | 54 | $261.17 | $289.49 | $368.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $821.00 / $1,963.00 / $4,852.00
| Facility | | $821.00 | $1,963.00 | $4,852.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.93 / $582.17 / $1,272.02
| Facility | | $377.93 | $582.17 | $1,272.02 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,347.91 / $1,347.91 / $1,347.91
| Facility | 54 | $1,347.91 | $1,347.91 | $1,347.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.00 / $815.00 / $1,351.00
| Facility | | $245.00 | $815.00 | $1,351.00 |