- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.68 / $2,145.78 / $7,838.38
| Facility | | $508.68 | $2,145.78 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $381.51 / $381.51 / $381.51
| Facility | 54 | $381.51 | $381.51 | $381.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,546.18 / $5,354.03 / $8,308.17
| Facility | | $1,546.18 | $5,354.03 | $8,308.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.78 / $548.79 / $738.92
| Facility | | $413.78 | $548.79 | $738.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.00 / $3,503.00 / $5,060.00
| Facility | | $559.00 | $3,503.00 | $5,060.00 |