- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.64 / $561.39 / $906.37
| Professional | | $377.64 | $561.39 | $906.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.62 / $583.94 / $753.74
| Professional | | $406.62 | $583.94 | $753.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.64 / $656.06 / $1,115.00
| Professional | | $465.64 | $656.06 | $1,115.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.07 / $677.73 / $707.99
| Professional | | $576.07 | $677.73 | $707.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.57 / $675.04 / $1,116.92
| Professional | | $429.57 | $675.04 | $1,116.92 |