- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $2,187.76 / $7,413.10
| Facility | | $549.54 | $2,187.76 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $741.31 / $1,202.26 / $1,905.46
| Facility | 54 | $741.31 | $1,202.26 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $5,011.87 / $10,964.78
| Facility | | $1,778.28 | $5,011.87 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,621.81 / $3,890.45
| Facility | | $794.33 | $1,621.81 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $562.34 / $562.34 / $562.34
| Facility | 54 | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $1,258.93 / $3,981.07
| Facility | | $302.00 | $1,258.93 | $3,981.07 |