- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $493.22 / $821.12 / $4,846.00
| Facility | | $493.22 | $821.12 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $330.56 / $369.92 / $612.39
| Facility | 54 | $330.56 | $369.92 | $612.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,943.00 / $5,126.00 / $8,240.00
| Facility | | $1,943.00 | $5,126.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.67 / $602.10 / $903.15
| Facility | | $438.67 | $602.10 | $903.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.45 / $1,123.45 / $1,331.74
| Facility | | $1,123.45 | $1,123.45 | $1,331.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.00 / $2,252.00 / $4,426.00
| Facility | | $933.00 | $2,252.00 | $4,426.00 |