- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.30 / $396.55 / $2,887.74
| Facility | | $154.30 | $396.55 | $2,887.74 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $77.15 / $157.97 / $419.57
| Facility | 53 | $77.15 | $157.97 | $419.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.02 / $537.02 / $1,404.00
| Facility | | $537.02 | $537.02 | $1,404.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,801.65 / $3,534.56 / $3,674.25
| Facility | | $1,801.65 | $3,534.56 | $3,674.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $414.00 / $1,320.00 / $1,320.00
| Facility | | $414.00 | $1,320.00 | $1,320.00 |