- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.53 / $3,498.00 / $10,439.00
| Facility | | $636.53 | $3,498.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $451.09 / $451.09 / $588.32
| Facility | 54 | $451.09 | $451.09 | $588.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.55 / $1,074.97 / $1,705.26
| Facility | | $730.55 | $1,074.97 | $1,705.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.00 / $330.00 / $330.00
| Facility | | $330.00 | $330.00 | $330.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.21 / $784.42 / $3,331.00
| Facility | | $501.21 | $784.42 | $3,331.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.00 / $2,081.00 / $3,918.00
| Facility | | $825.00 | $2,081.00 | $3,918.00 |