- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.51 / $251.84 / $357.12
| Professional | | $155.51 | $251.84 | $357.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.51 / $451.88 / $636.29
| Professional | | $328.51 | $451.88 | $636.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.35 / $301.70 / $415.57
| Professional | | $158.35 | $301.70 | $415.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.63 / $427.10 / $1,475.18
| Professional | | $235.63 | $427.10 | $1,475.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.46 / $426.33 / $598.19
| Professional | | $328.46 | $426.33 | $598.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.71 / $337.84 / $629.23
| Professional | | $221.71 | $337.84 | $629.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.00 / $364.70 / $511.10
| Professional | | $310.00 | $364.70 | $511.10 |