- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $677.55 / $3,690.00 / $10,802.00
| Facility | | $677.55 | $3,690.00 | $10,802.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $463.77 / $507.89 / $508.16
| Facility | 54 | $463.77 | $507.89 | $508.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.00 / $835.58 / $994.74
| Facility | | $432.00 | $835.58 | $994.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,578.00 / $4,823.00 / $9,635.00
| Facility | | $2,578.00 | $4,823.00 | $9,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591.00 / $2,671.00 / $6,077.00
| Facility | | $591.00 | $2,671.00 | $6,077.00 |