- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.59 / $3,636.59 / $12,765.09
| Facility | | $485.59 | $3,636.59 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $324.75 / $324.75 / $364.19
| Facility | 54 | $324.75 | $324.75 | $364.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,350.61 / $4,406.97 / $8,524.51
| Facility | | $3,350.61 | $4,406.97 | $8,524.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,257.44 / $1,257.44 / $1,257.44
| Facility | | $1,257.44 | $1,257.44 | $1,257.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.03 / $801.22 / $1,775.00
| Facility | | $437.03 | $801.22 | $1,775.00 |
- 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
- $953.00 / $1,219.17 / $1,597.29
| Facility | | $953.00 | $1,219.17 | $1,597.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |