- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $357.51 / $2,324.00 / $10,632.00
| Facility | | $357.51 | $2,324.00 | $10,632.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $175.64 / $240.66 / $301.64
| Facility | 54 | $175.64 | $240.66 | $301.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.39 / $272.70 / $494.00
| Facility | | $268.39 | $272.70 | $494.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,752.00 / $2,882.00 / $6,066.00
| Facility | | $1,752.00 | $2,882.00 | $6,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.00 / $1,950.00 / $4,970.00
| Facility | | $366.00 | $1,950.00 | $4,970.00 |