- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.06 / $1,449.00 / $9,450.00
| Facility | | $85.06 | $1,449.00 | $9,450.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $55.05 / $63.80 / $75.97
| Facility | 54 | $55.05 | $63.80 | $75.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.67 / $76.73 / $91.35
| Facility | | $75.67 | $76.73 | $91.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,438.00 / $2,403.00 / $4,241.00
| Facility | | $1,438.00 | $2,403.00 | $4,241.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.00 / $1,950.00 / $5,107.00
| Facility | | $366.00 | $1,950.00 | $5,107.00 |