- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $2,368.92 / $8,229.00
| Facility | | $860.00 | $2,368.92 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $345.19 / $360.44 / $536.28
| Facility | 53 | $345.19 | $360.44 | $536.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.58 / $2,670.47 / $11,253.00
| Facility | | $884.58 | $2,670.47 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.12 / $2,293.69 / $2,645.94
| Facility | | $1,671.12 | $2,293.69 | $2,645.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,020.20 / $2,020.20 / $2,020.20
| Facility | | $2,020.20 | $2,020.20 | $2,020.20 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $394.00 / $394.00 / $394.00
| Facility | 53 | $394.00 | $394.00 | $394.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,231.24 / $1,231.24 / $1,231.24
| Facility | 62 | $1,231.24 | $1,231.24 | $1,231.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $4,298.00 / $30,001.00
| Facility | | $599.00 | $4,298.00 | $30,001.00 |