- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.08 / $1,486.00 / $3,469.00
| Facility | | $525.08 | $1,486.00 | $3,469.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $327.05 / $327.05 / $364.33
| Facility | 54 | $327.05 | $327.05 | $364.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $736.00 / $1,856.00 / $4,142.00
| Facility | | $736.00 | $1,856.00 | $4,142.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,700.44 / $1,700.44 / $1,700.44
| Facility | 54 | $1,700.44 | $1,700.44 | $1,700.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $570.20 / $732.71 / $1,308.04
| Facility | | $570.20 | $732.71 | $1,308.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.59 / $1,039.70 / $6,679.00
| Facility | | $478.59 | $1,039.70 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.17 / $1,183.42 / $3,055.54
| Facility | | $262.17 | $1,183.42 | $3,055.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $2,217.00 / $16,394.00
| Facility | | $627.00 | $2,217.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,700.44 / $1,700.44 / $1,700.44
| Facility | 54 | $1,700.44 | $1,700.44 | $1,700.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |