- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.61 / $4,305.00 / $8,031.00
| Facility | | $175.61 | $4,305.00 | $8,031.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $99.81 / $131.71 / $175.96
| Facility | 54 | $99.81 | $131.71 | $175.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,786.00 / $8,848.00 / $29,890.00
| Facility | | $5,786.00 | $8,848.00 | $29,890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $210.92 / $210.92
| Facility | | $50.00 | $210.92 | $210.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,005.87 / $1,643.00 / $1,677.00
| Facility | | $1,005.87 | $1,643.00 | $1,677.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.00 / $3,075.00 / $6,664.00
| Facility | | $1,380.00 | $3,075.00 | $6,664.00 |