- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.44 / $496.02 / $534.25
| Professional | | $368.44 | $496.02 | $534.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.62 / $496.31 / $1,489.15
| Professional | | $416.62 | $496.31 | $1,489.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.87 / $715.21 / $932.93
| Professional | | $463.87 | $715.21 | $932.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $433.66 / $627.27 / $932.93
| Professional | | $433.66 | $627.27 | $932.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.73 / $585.96 / $1,703.42
| Professional | | $565.73 | $585.96 | $1,703.42 |