- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.60 / $886.35 / $1,831.00
| Facility | | $289.60 | $886.35 | $1,831.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $57.92 / $88.45 / $221.13
| Facility | 53 | $57.92 | $88.45 | $221.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.86 / $526.86 / $579.54
| Facility | | $526.86 | $526.86 | $579.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.00 / $443.02 / $1,373.51
| Facility | | $415.00 | $443.02 | $1,373.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.00 / $1,305.00 / $3,191.00
| Facility | | $575.00 | $1,305.00 | $3,191.00 |