- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $461.43 / $1,773.00 / $5,634.00
| Facility | | $461.43 | $1,773.00 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $346.07 / $346.07 / $573.98
| Facility | 54 | $346.07 | $346.07 | $573.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.00 / $3,840.00 / $7,747.00
| Facility | | $1,636.00 | $3,840.00 | $7,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $461.90 / $633.98 / $950.97
| Facility | | $461.90 | $633.98 | $950.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.45 / $1,123.45 / $1,331.74
| Facility | | $1,123.45 | $1,123.45 | $1,331.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $3,874.00 / $5,490.00
| Facility | | $2,400.00 | $3,874.00 | $5,490.00 |