- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.53 / $2,451.00 / $7,119.04
| Facility | | $636.53 | $2,451.00 | $7,119.04 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $372.21 / $390.37 / $572.94
| Facility | 54 | $372.21 | $390.37 | $572.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,723.00 / $3,693.00 / $5,962.00
| Facility | | $1,723.00 | $3,693.00 | $5,962.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $566.54 / $835.58 / $1,153.31
| Facility | | $566.54 | $835.58 | $1,153.31 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $394.33 / $394.33 / $394.33
| Facility | 54 | $394.33 | $394.33 | $394.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.00 / $2,600.00 / $5,490.00
| Facility | | $1,185.00 | $2,600.00 | $5,490.00 |