- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.29 / $374.76 / $602.26
| Professional | | $264.29 | $374.76 | $602.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.92 / $564.86 / $912.68
| Professional | | $343.92 | $564.86 | $912.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.37 / $462.51 / $847.93
| Professional | | $317.37 | $462.51 | $847.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.37 / $495.00 / $495.00
| Professional | | $454.37 | $495.00 | $495.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $506.60 / $1,059.59
| Professional | | $5.00 | $506.60 | $1,059.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.56 / $449.48 / $995.73
| Professional | | $325.56 | $449.48 | $995.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,001.28 / $2,767.12 / $3,206.93
| Professional | | $2,001.28 | $2,767.12 | $3,206.93 |