- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.42 / $5,000.27 / $7,838.38
| Facility | | $771.42 | $5,000.27 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $578.57 / $578.57 / $578.57
| Facility | 54 | $578.57 | $578.57 | $578.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,860.01 / $6,440.74 / $9,994.48
| Facility | | $1,860.01 | $6,440.74 | $9,994.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $690.06 / $901.00 / $1,151.38
| Facility | | $690.06 | $901.00 | $1,151.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.00 / $3,503.00 / $6,999.76
| Facility | | $559.00 | $3,503.00 | $6,999.76 |