- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.57 / $254.39 / $934.05
| Professional | | $161.57 | $254.39 | $934.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.19 / $327.38 / $518.45
| Professional | | $171.19 | $327.38 | $518.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.60 / $528.69 / $788.84
| Professional | | $281.60 | $528.69 | $788.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.91 / $550.62 / $1,306.48
| Professional | | $336.91 | $550.62 | $1,306.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.41 / $510.74 / $725.95
| Professional | | $360.41 | $510.74 | $725.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.91 / $556.28 / $717.44
| Professional | | $336.91 | $556.28 | $717.44 |