- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.97 / $1,066.45 / $11,093.00
| Facility | | $306.97 | $1,066.45 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $230.23 / $353.24 / $389.71
| Facility | 54 | $230.23 | $353.24 | $389.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,073.00 / $5,061.00 / $9,462.00
| Facility | | $2,073.00 | $5,061.00 | $9,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.16 / $376.04 / $592.97
| Facility | | $258.16 | $376.04 | $592.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.92 / $365.92 / $365.92
| Facility | | $365.92 | $365.92 | $365.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.00 / $2,252.00 / $4,426.00
| Facility | | $933.00 | $2,252.00 | $4,426.00 |