- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $285.83 / $296.82 / $333.71
| Facility | 54 | $285.83 | $296.82 | $333.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.02 / $341.58 / $595.27
| Professional | | $240.02 | $341.58 | $595.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.06 / $334.30 / $767.45
| Professional | | $79.06 | $334.30 | $767.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.96 / $344.79 / $638.47
| Professional | | $249.96 | $344.79 | $638.47 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $285.83 / $285.83 / $321.35
| Facility | 54 | $285.83 | $285.83 | $321.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.35 / $382.63 / $595.27
| Professional | | $301.35 | $382.63 | $595.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.30 / $180.50 / $404.72
| Professional | | $32.30 | $180.50 | $404.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.27 / $372.01 / $512.41
| Professional | | $309.27 | $372.01 | $512.41 |