- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.81 / $315.91 / $522.02
| Professional | | $236.81 | $315.91 | $522.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $269.81 / $508.50 / $742.89
| Professional | 50 | $269.81 | $508.50 | $742.89 |
- Facility/Professional
- Professional
- Modifier
- 54
- Low / Median / High Price
- $177.61 / $239.19 / $937.04
| Professional | 54 | $177.61 | $239.19 | $937.04 |
- Facility/Professional
- Professional
- Modifier
- 55
- Low / Median / High Price
- $35.52 / $47.84 / $187.41
| Professional | 55 | $35.52 | $47.84 | $187.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $922.99 / $958.59 / $1,035.61
| Facility | | $922.99 | $958.59 | $1,035.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $571.87 / $674.12 / $1,086.83
| Professional | | $571.87 | $674.12 | $1,086.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.41 / $461.34 / $752.00
| Professional | | $325.41 | $461.34 | $752.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.30 / $442.48 / $752.00
| Professional | | $309.30 | $442.48 | $752.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.30 / $520.28 / $1,239.08
| Professional | | $362.30 | $520.28 | $1,239.08 |