- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $23,483.17
| Facility | | $4,241.22 | $10,431.19 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $534.44 / $534.44 / $534.44
| Facility | 54 | $534.44 | $534.44 | $534.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,007.90 / $3,924.55 / $7,652.58
| Facility | | $3,007.90 | $3,924.55 | $7,652.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.47 / $1,821.47 / $1,821.47
| Facility | | $1,821.47 | $1,821.47 | $1,821.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $717.02 / $1,505.52 / $6,887.55
| Facility | | $717.02 | $1,505.52 | $6,887.55 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $4,569.92 / $4,569.92 / $4,569.92
| Facility | 54 | $4,569.92 | $4,569.92 | $4,569.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,228.08 / $1,821.47 / $2,333.86
| Facility | | $1,228.08 | $1,821.47 | $2,333.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |