- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.57 / $1,851.50 / $11,674.00
| Facility | | $563.57 | $1,851.50 | $11,674.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $277.88 / $422.68 / $879.35
| Facility | 54 | $277.88 | $422.68 | $879.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,028.58 / $1,864.94 / $3,078.72
| Facility | | $1,028.58 | $1,864.94 | $3,078.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.43 / $446.43 / $580.00
| Facility | | $446.43 | $446.43 | $580.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.47 / $469.44 / $648.11
| Facility | | $310.47 | $469.44 | $648.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $1,221.00 / $3,585.00
| Facility | | $225.00 | $1,221.00 | $3,585.00 |