- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.38 / $492.23 / $677.56
| Professional | | $339.38 | $492.23 | $677.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.51 / $525.62 / $751.58
| Professional | | $453.51 | $525.62 | $751.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $484.30 / $746.70 / $1,088.35
| Professional | | $484.30 | $746.70 | $1,088.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.04 / $646.74 / $1,147.90
| Professional | | $488.04 | $646.74 | $1,147.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.32 / $492.23 / $731.83
| Professional | | $358.32 | $492.23 | $731.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.74 / $695.95 / $945.66
| Professional | | $460.74 | $695.95 | $945.66 |