- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.01 / $541.38 / $905.71
| Professional | | $371.01 | $541.38 | $905.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.91 / $556.36 / $849.39
| Professional | | $472.91 | $556.36 | $849.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $570.41 / $936.48 / $1,495.51
| Professional | | $570.41 | $936.48 | $1,495.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.12 / $884.17 / $1,520.88
| Professional | | $558.12 | $884.17 | $1,520.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.01 / $541.38 / $905.71
| Professional | | $371.01 | $541.38 | $905.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $598.40 / $867.69 / $1,501.36
| Professional | | $598.40 | $867.69 | $1,501.36 |