- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.08 / $557.08 / $7,838.38
| Facility | | $557.08 | $557.08 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $359.15 / $359.15 / $401.57
| Facility | 54 | $359.15 | $359.15 | $401.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $484.77 / $1,777.55 / $2,672.80
| Facility | | $484.77 | $1,777.55 | $2,672.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.89 / $570.32 / $763.63
| Facility | | $480.89 | $570.32 | $763.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.00 / $1,158.00 / $1,401.00
| Facility | | $230.00 | $1,158.00 | $1,401.00 |