- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $467.74 / $977.24
| Professional | | $371.54 | $467.74 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $616.60 / $891.25
| Professional | | $398.11 | $616.60 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $575.44 / $933.25
| Professional | | $436.52 | $575.44 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $588.84 / $1,122.02
| Professional | | $489.78 | $588.84 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $562.34 / $1,202.26
| Professional | | $380.19 | $562.34 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $512.86 / $870.96
| Professional | | $346.74 | $512.86 | $870.96 |