- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.04 / $2,006.30 / $5,687.00
| Facility | | $559.04 | $2,006.30 | $5,687.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $301.14 / $336.55 / $422.54
| Facility | 54 | $301.14 | $336.55 | $422.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $821.00 / $1,963.00 / $4,852.00
| Facility | | $821.00 | $1,963.00 | $4,852.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.37 / $689.09 / $1,429.16
| Facility | | $433.37 | $689.09 | $1,429.16 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,534.41 / $1,534.41 / $1,534.41
| Facility | 54 | $1,534.41 | $1,534.41 | $1,534.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.00 / $815.00 / $1,351.00
| Facility | | $245.00 | $815.00 | $1,351.00 |