- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.30 / $3,908.01 / $13,841.56
| Facility | | $115.30 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $64.20 / $64.20 / $86.48
| Facility | 54 | $64.20 | $64.20 | $86.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,350.61 / $4,406.97 / $8,524.51
| Facility | | $3,350.61 | $4,406.97 | $8,524.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.47 / $115.47 / $115.47
| Facility | | $115.47 | $115.47 | $115.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.02 / $190.25 / $390.50
| Facility | | $101.02 | $190.25 | $390.50 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $306.24 / $306.24 / $306.24
| Facility | 54 | $306.24 | $306.24 | $306.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.02 / $210.21 / $336.11
| Facility | | $127.02 | $210.21 | $336.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |