- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.54 / $467.02 / $4,828.00
| Facility | | $297.54 | $467.02 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $223.16 / $350.27 / $350.27
| Facility | 54 | $223.16 | $350.27 | $350.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.05 / $1,538.59 / $2,605.48
| Facility | | $715.05 | $1,538.59 | $2,605.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,205.28 / $1,709.24 / $4,111.80
| Facility | | $1,205.28 | $1,709.24 | $4,111.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $979.81 / $1,562.65 / $3,237.64
| Facility | | $979.81 | $1,562.65 | $3,237.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.50 / $604.38 / $1,360.92
| Facility | | $344.50 | $604.38 | $1,360.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.00 / $1,749.00 / $2,883.00
| Facility | | $563.00 | $1,749.00 | $2,883.00 |