- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,548.82 / $9,120.11
| Facility | | $602.56 | $1,548.82 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $741.31 / $741.31 / $741.31
| Facility | 54 | $741.31 | $741.31 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,202.26 / $2,570.40
| Facility | | $676.08 | $1,202.26 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $776.25 / $1,380.38
| Facility | | $501.19 | $776.25 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $562.34 / $562.34 / $562.34
| Facility | 54 | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $1,202.26
| Professional | | $831.76 | $831.76 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $660.69 / $1,122.02
| Facility | | $478.63 | $660.69 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,230.27 / $4,677.35
| Facility | | $354.81 | $1,230.27 | $4,677.35 |