- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $2,500.00 / $4,050.00
| Facility | | $678.00 | $2,500.00 | $4,050.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $164.21 / $164.21 / $196.49
| Facility | 53 | $164.21 | $164.21 | $196.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,439.57 / $19,944.78 / $29,460.88
| Facility | | $10,439.57 | $19,944.78 | $29,460.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.28 / $615.28 / $615.28
| Facility | | $615.28 | $615.28 | $615.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,656.00 / $8,813.00 / $19,124.00
| Facility | | $5,656.00 | $8,813.00 | $19,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $5,780.00 / $13,506.00
| Facility | | $1,200.00 | $5,780.00 | $13,506.00 |