- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,243.00 / $5,325.00 / $16,173.00
| Facility | | $2,243.00 | $5,325.00 | $16,173.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $154.03 / $154.03 / $168.37
| Facility | 53 | $154.03 | $154.03 | $168.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,086.85 / $26,537.97 / $32,082.25
| Facility | | $12,086.85 | $26,537.97 | $32,082.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,968.00 / $27,391.00 / $34,239.00
| Facility | | $22,968.00 | $27,391.00 | $34,239.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.80 / $2,324.00 / $16,026.00
| Facility | | $641.80 | $2,324.00 | $16,026.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,081.00 / $7,665.00 / $19,827.00
| Facility | | $3,081.00 | $7,665.00 | $19,827.00 |