- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.24 / $455.24 / $7,838.38
| Facility | | $455.24 | $455.24 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $311.95 / $311.95 / $346.31
| Facility | 54 | $311.95 | $311.95 | $346.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $484.77 / $1,724.33 / $2,604.83
| Facility | | $484.77 | $1,724.33 | $2,604.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $304.02 / $454.48 / $591.86
| Facility | | $304.02 | $454.48 | $591.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.00 / $1,158.00 / $1,401.00
| Facility | | $230.00 | $1,158.00 | $1,401.00 |