- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.45 / $736.14 / $889.97
| Professional | | $582.45 | $736.14 | $889.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $730.67 / $945.58 / $1,342.46
| Professional | | $730.67 | $945.58 | $1,342.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.17 / $1,042.69 / $1,511.33
| Professional | | $676.17 | $1,042.69 | $1,511.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $876.75 / $1,014.40 / $1,556.14
| Professional | | $876.75 | $1,014.40 | $1,556.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.45 / $762.62 / $889.97
| Professional | | $582.45 | $762.62 | $889.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $605.16 / $976.01 / $1,397.95
| Professional | | $605.16 | $976.01 | $1,397.95 |