- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.97 / $261.33 / $694.81
| Professional | | $156.97 | $261.33 | $694.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.64 / $425.25 / $703.86
| Professional | | $250.64 | $425.25 | $703.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.88 / $431.39 / $635.50
| Professional | | $340.88 | $431.39 | $635.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.64 / $399.33 / $589.12
| Professional | | $271.64 | $399.33 | $589.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.14 / $452.72 / $676.86
| Professional | | $306.14 | $452.72 | $676.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.39 / $478.50 / $728.05
| Professional | | $307.39 | $478.50 | $728.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.67 / $504.69 / $806.00
| Professional | | $355.67 | $504.69 | $806.00 |