- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,630.78 / $15,848.93
| Facility | | $870.96 | $3,630.78 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $257.04 / $257.04 / $257.04
| Facility | 53 | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $151.36 / $2,454.71
| Facility | | $109.65 | $151.36 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $13,803.84 / $19,952.62
| Facility | | $12,589.25 | $13,803.84 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $54,954.09 / $54,954.09
| Facility | | $54.95 | $54,954.09 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $43,651.58
| Facility | 52 | $43,651.58 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $10,964.78 / $10,964.78 / $10,964.78
| Facility | 53 | $10,964.78 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $14,125.38 / $26,915.35
| Facility | | $8,128.31 | $14,125.38 | $26,915.35 |