- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.00 / $927.00 / $2,250.00
| Facility | | $485.00 | $927.00 | $2,250.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $340.49 / $340.49 / $365.21
| Facility | 54 | $340.49 | $340.49 | $365.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.43 / $272.83 / $486.94
| Professional | | $229.43 | $272.83 | $486.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.45 / $314.45 / $314.45
| Professional | | $314.45 | $314.45 | $314.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.89 / $717.74 / $965.59
| Facility | | $592.89 | $717.74 | $965.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.50 / $313.50 / $391.01
| Professional | | $213.50 | $313.50 | $391.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.81 / $337.79 / $935.64
| Professional | | $243.81 | $337.79 | $935.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.00 / $850.00 / $1,349.00
| Facility | | $241.00 | $850.00 | $1,349.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.38 / $289.83 / $488.91
| Professional | | $237.38 | $289.83 | $488.91 |