- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.00 / $1,256.27 / $3,500.00
| Facility | | $453.00 | $1,256.27 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $299.42 / $318.77 / $401.34
| Facility | 54 | $299.42 | $318.77 | $401.34 |
- Facility/Professional
- Facility
- Modifier
- 55
- Low / Median / High Price
- $59.88 / $63.75 / $80.27
| Facility | 55 | $59.88 | $63.75 | $80.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.14 / $399.22 / $608.74
| Professional | | $269.14 | $399.22 | $608.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $603.69 / $603.69 / $603.69
| Professional | 50 | $603.69 | $603.69 | $603.69 |
- Facility/Professional
- Professional
- Modifier
- 54
- Low / Median / High Price
- $241.89 / $359.74 / $425.09
| Professional | 54 | $241.89 | $359.74 | $425.09 |
- Facility/Professional
- Professional
- Modifier
- 55
- Low / Median / High Price
- $48.38 / $71.95 / $85.02
| Professional | 55 | $48.38 | $71.95 | $85.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.18 / $496.18 / $496.18
| Professional | | $496.18 | $496.18 | $496.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.92 / $924.39 / $1,422.71
| Facility | | $503.92 | $924.39 | $1,422.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.06 / $426.04 / $523.77
| Professional | | $358.06 | $426.04 | $523.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.43 / $477.43 / $477.43
| Facility | | $477.43 | $477.43 | $477.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.00 / $600.00 / $600.00
| Facility | | $600.00 | $600.00 | $600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.45 / $364.61 / $518.97
| Professional | | $257.45 | $364.61 | $518.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.00 / $1,049.00 / $2,271.00
| Facility | | $341.00 | $1,049.00 | $2,271.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.65 / $348.30 / $586.33
| Professional | | $247.65 | $348.30 | $586.33 |