- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.00 / $4,805.00 / $10,000.00
| Facility | | $1,048.00 | $4,805.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $613.16 / $638.55 / $890.93
| Facility | 54 | $613.16 | $638.55 | $890.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,740.00 / $4,247.00 / $9,074.00
| Facility | | $2,740.00 | $4,247.00 | $9,074.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.00 / $1,277.64 / $1,593.42
| Facility | | $1,248.00 | $1,277.64 | $1,593.42 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $610.67 / $610.67 / $610.67
| Facility | 54 | $610.67 | $610.67 | $610.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,683.00 / $3,833.00 / $7,790.50
| Facility | | $1,683.00 | $3,833.00 | $7,790.50 |