- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.97 / $6,086.00 / $17,958.00
| Facility | | $615.97 | $6,086.00 | $17,958.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $111.60 / $117.88 / $123.19
| Facility | 53 | $111.60 | $117.88 | $123.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,742.00 / $16,521.00 / $38,010.00
| Facility | | $7,742.00 | $16,521.00 | $38,010.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,312.00 / $24,073.00 / $46,234.00
| Facility | | $13,312.00 | $24,073.00 | $46,234.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,072.00 / $19,732.00 / $35,288.00
| Facility | | $4,072.00 | $19,732.00 | $35,288.00 |