- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.54 / $462.02 / $506.88
| Facility | | $362.54 | $462.02 | $506.88 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $760.31 / $760.31 / $760.31
| Facility | 50 | $760.31 | $760.31 | $760.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.80 / $362.54 / $482.63
| Professional | | $243.80 | $362.54 | $482.63 |
- Facility/Professional
- Professional
- Modifier
- 54
- Low / Median / High Price
- $271.91 / $283.06 / $356.64
| Professional | 54 | $271.91 | $283.06 | $356.64 |
- Facility/Professional
- Professional
- Modifier
- 55
- Low / Median / High Price
- $54.38 / $56.61 / $71.33
| Professional | 55 | $54.38 | $56.61 | $71.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.59 / $301.82 / $392.16
| Professional | | $253.59 | $301.82 | $392.16 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $380.38 / $452.73 / $588.24
| Professional | 50 | $380.38 | $452.73 | $588.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.64 / $531.64 / $531.64
| Facility | | $531.64 | $531.64 | $531.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.26 / $466.14 / $604.75
| Professional | | $363.26 | $466.14 | $604.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.13 / $363.15 / $565.05
| Professional | | $288.13 | $363.15 | $565.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.88 / $506.88 / $506.88
| Facility | | $506.88 | $506.88 | $506.88 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $760.31 / $760.31 / $760.31
| Facility | 50 | $760.31 | $760.31 | $760.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.06 / $362.54 / $479.04
| Professional | | $260.06 | $362.54 | $479.04 |
- Facility/Professional
- Professional
- Modifier
- 54
- Low / Median / High Price
- $271.91 / $271.91 / $346.52
| Professional | 54 | $271.91 | $271.91 | $346.52 |
- Facility/Professional
- Professional
- Modifier
- 55
- Low / Median / High Price
- $54.38 / $54.38 / $69.30
| Professional | 55 | $54.38 | $54.38 | $69.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.50 / $409.00 / $544.57
| Professional | | $286.50 | $409.00 | $544.57 |