- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.47 / $245.17 / $428.17
| Professional | | $155.47 | $245.17 | $428.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.05 / $245.18 / $565.29
| Professional | | $193.05 | $245.18 | $565.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.49 / $223.49 / $369.11
| Professional | | $223.49 | $223.49 | $369.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.33 / $322.18 / $802.73
| Professional | | $170.33 | $322.18 | $802.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.64 / $386.21 / $568.02
| Professional | | $274.64 | $386.21 | $568.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.38 / $260.83 / $541.29
| Professional | | $203.38 | $260.83 | $541.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.69 / $338.39 / $777.91
| Professional | | $176.69 | $338.39 | $777.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.06 / $323.85 / $879.41
| Professional | | $224.06 | $323.85 | $879.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.38 / $328.69 / $541.29
| Professional | | $203.38 | $328.69 | $541.29 |