- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.35 / $480.35 / $534.51
| Professional | | $480.35 | $480.35 | $534.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $587.94 / $693.05 / $1,644.93
| Professional | | $587.94 | $693.05 | $1,644.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.29 / $693.49 / $932.42
| Professional | | $492.29 | $693.49 | $932.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $429.75 / $617.25 / $932.42
| Professional | | $429.75 | $617.25 | $932.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.16 / $585.63 / $1,702.48
| Professional | | $486.16 | $585.63 | $1,702.48 |