- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.75 / $1,240.40 / $9,358.01
| Facility | | $596.75 | $1,240.40 | $9,358.01 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $406.12 / $746.20 / $1,031.65
| Facility | 54 | $406.12 | $746.20 | $1,031.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $692.62 / $1,260.07 / $2,661.09
| Facility | | $692.62 | $1,260.07 | $2,661.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $780.00 / $1,370.63
| Facility | | $505.00 | $780.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $560.79 / $560.79 / $560.79
| Facility | 54 | $560.79 | $560.79 | $560.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.01 / $664.69 / $1,077.33
| Facility | | $517.01 | $664.69 | $1,077.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $1,221.00 / $3,585.00
| Facility | | $225.00 | $1,221.00 | $3,585.00 |