- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $836.09 / $836.09 / $7,397.00
| Facility | | $836.09 | $836.09 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $627.07 / $627.07 / $627.07
| Facility | 54 | $627.07 | $627.07 | $627.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.61 / $5,357.75 / $10,376.78
| Facility | | $3,028.61 | $5,357.75 | $10,376.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,947.15 / $2,762.73 / $6,646.12
| Facility | | $1,947.15 | $2,762.73 | $6,646.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,583.71 / $2,525.80 / $5,233.16
| Facility | | $1,583.71 | $2,525.80 | $5,233.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.72 / $1,478.65 / $5,499.18
| Facility | | $847.72 | $1,478.65 | $5,499.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |