- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.34 / $2,845.00 / $9,133.00
| Facility | | $342.34 | $2,845.00 | $9,133.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $51.94 / $130.29 / $276.67
| Facility | 53 | $51.94 | $130.29 | $276.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $683.05 / $956.62 / $1,592.44
| Facility | | $683.05 | $956.62 | $1,592.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.00 / $596.00 / $626.00
| Facility | | $543.00 | $596.00 | $626.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.02 / $346.85 / $1,145.00
| Facility | | $165.02 | $346.85 | $1,145.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.00 / $2,081.00 / $3,918.00
| Facility | | $816.00 | $2,081.00 | $3,918.00 |