- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.45 / $3,751.00 / $10,632.00
| Facility | | $678.45 | $3,751.00 | $10,632.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $478.91 / $508.10 / $508.84
| Facility | 54 | $478.91 | $508.10 | $508.84 |
- 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
- $1,014.00 / $3,611.00 / $8,105.00
| Facility | | $1,014.00 | $3,611.00 | $8,105.00 |