- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $249.79 / $3,087.00 / $10,086.00
| Facility | | $249.79 | $3,087.00 | $10,086.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $28.38 / $54.24 / $127.27
| Facility | 53 | $28.38 | $54.24 | $127.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.52 / $487.89 / $1,652.00
| Facility | | $263.52 | $487.89 | $1,652.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $52.70 / $52.70 / $415.88
| Facility | 53 | $52.70 | $52.70 | $415.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,894.00 / $3,083.00 / $6,645.00
| Facility | | $1,894.00 | $3,083.00 | $6,645.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.00 / $3,514.00 / $7,044.00
| Facility | | $573.00 | $3,514.00 | $7,044.00 |