- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,570.40 / $7,413.10
| Facility | | $1,000.00 | $2,570.40 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,819.70 / $4,168.69
| Facility | | $676.08 | $1,819.70 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $954.99 / $5,011.87
| Facility | | $575.44 | $954.99 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,230.27 / $3,162.28 / $3,162.28
| Facility | 54 | $1,230.27 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $724.44 / $1,778.28
| Facility | | $346.74 | $724.44 | $1,778.28 |