- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $2,344.23 / $7,413.10
| Facility | | $302.00 | $2,344.23 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $81.28 / $158.49 / $302.00
| Facility | 53 | $81.28 | $158.49 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $8,709.64
| Facility | | $1,348.96 | $3,548.13 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $660.69 / $1,584.89
| Facility | | $263.03 | $660.69 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $52.48 / $52.48 / $52.48
| Facility | 53 | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $2,511.89 / $6,025.60
| Facility | | $645.65 | $2,511.89 | $6,025.60 |