- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $634.00 / $1,140.00 / $2,271.44
| Facility | | $634.00 | $1,140.00 | $2,271.44 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $91.05 / $91.05 / $454.29
| Facility | 53 | $91.05 | $91.05 | $454.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,973.26 / $10,973.26 / $10,973.26
| Facility | | $10,973.26 | $10,973.26 | $10,973.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,900.26 / $16,508.45 / $31,086.00
| Facility | | $7,900.26 | $16,508.45 | $31,086.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,390.00 / $10,905.00 / $19,044.00
| Facility | | $1,390.00 | $10,905.00 | $19,044.00 |