- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.64 / $509.71 / $990.88
| Professional | | $319.64 | $509.71 | $990.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $868.00 / $868.00 / $868.00
| Professional | | $868.00 | $868.00 | $868.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.66 / $632.13 / $914.60
| Professional | | $410.66 | $632.13 | $914.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.28 / $567.27 / $1,120.30
| Professional | | $437.28 | $567.27 | $1,120.30 |