- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.02 / $3,785.00 / $10,268.00
| Facility | | $464.02 | $3,785.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $234.04 / $413.51 / $1,080.71
| Facility | 54 | $234.04 | $413.51 | $1,080.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,051.00 / $2,191.00 / $4,072.00
| Facility | | $1,051.00 | $2,191.00 | $4,072.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.52 / $446.35 / $446.35
| Facility | | $306.52 | $446.35 | $446.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $898.38 / $898.38 / $898.38
| Facility | | $898.38 | $898.38 | $898.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.00 / $975.00 / $2,914.00
| Facility | | $444.00 | $975.00 | $2,914.00 |