- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $233.47 / $234.36 / $265.07
| Facility | 54 | $233.47 | $234.36 | $265.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.35 / $312.48 / $595.27
| Professional | | $267.35 | $312.48 | $595.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.25 / $467.25 / $467.25
| Professional | | $467.25 | $467.25 | $467.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.42 / $355.34 / $577.29
| Professional | | $342.42 | $355.34 | $577.29 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $357.43 / $357.43 / $357.43
| Facility | 54 | $357.43 | $357.43 | $357.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.58 / $371.50 / $621.80
| Professional | | $274.58 | $371.50 | $621.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.90 / $555.00 / $711.46
| Professional | | $411.90 | $555.00 | $711.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.21 / $355.48 / $788.95
| Professional | | $329.21 | $355.48 | $788.95 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $234.36 / $234.36 / $265.07
| Facility | 54 | $234.36 | $234.36 | $265.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.29 / $342.80 / $698.11
| Professional | | $270.29 | $342.80 | $698.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.60 / $327.60 / $705.80
| Professional | | $327.60 | $327.60 | $705.80 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $357.43 / $357.43 / $357.43
| Facility | 54 | $357.43 | $357.43 | $357.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.18 / $377.26 / $625.63
| Professional | | $285.18 | $377.26 | $625.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.11 / $314.99 / $356.05
| Professional | | $287.11 | $314.99 | $356.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.12 / $396.65 / $643.90
| Professional | | $286.12 | $396.65 | $643.90 |