- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.40 / $2,881.44 / $8,040.00
| Facility | | $452.40 | $2,881.44 | $8,040.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $289.12 / $307.19 / $339.30
| Facility | 54 | $289.12 | $307.19 | $339.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.00 / $835.58 / $994.74
| Facility | | $432.00 | $835.58 | $994.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,578.00 / $4,823.00 / $9,635.00
| Facility | | $2,578.00 | $4,823.00 | $9,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.00 / $1,950.00 / $5,107.00
| Facility | | $366.00 | $1,950.00 | $5,107.00 |