- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $3,008.00 / $6,483.00
| Facility | | $1,582.00 | $3,008.00 | $6,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.35 / $2,197.38 / $3,616.69
| Facility | | $587.35 | $2,197.38 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $726.38 / $964.06 / $3,265.00
| Facility | | $726.38 | $964.06 | $3,265.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,345.34 / $1,345.34 / $3,154.80
| Facility | 54 | $1,345.34 | $1,345.34 | $3,154.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,578.00 / $2,522.00 / $5,029.00
| Facility | | $1,578.00 | $2,522.00 | $5,029.00 |