- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $3,090.30 / $9,120.11
| Facility | | $741.31 | $3,090.30 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,513.56 / $1,513.56 / $1,513.56
| Facility | 54 | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $4,168.69 / $10,000.00
| Facility | | $1,548.82 | $4,168.69 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,288.25 / $3,630.78
| Facility | | $562.34 | $1,288.25 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $588.84 / $588.84 / $588.84
| Facility | 54 | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,884.03 / $6,309.57
| Facility | | $1,000.00 | $2,884.03 | $6,309.57 |