- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.52 / $3,745.90 / $11,572.34
| Facility | | $571.52 | $3,745.90 | $11,572.34 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $343.70 / $380.00 / $596.77
| Facility | 54 | $343.70 | $380.00 | $596.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.62 / $554.71 / $604.37
| Facility | | $499.62 | $554.71 | $604.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.14 / $801.14 / $801.14
| Facility | | $801.14 | $801.14 | $801.14 |
- 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
- $1,749.02 / $5,727.06 / $7,820.60
| Facility | | $1,749.02 | $5,727.06 | $7,820.60 |