- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $683.55 / $810.99 / $1,025.44
| Professional | | $683.55 | $810.99 | $1,025.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $980.84 / $1,098.30 / $1,586.45
| Professional | | $980.84 | $1,098.30 | $1,586.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $978.71 / $1,172.71 / $1,818.41
| Professional | | $978.71 | $1,172.71 | $1,818.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $926.12 / $1,192.76 / $1,829.76
| Professional | | $926.12 | $1,192.76 | $1,829.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $683.55 / $938.46 / $1,025.44
| Professional | | $683.55 | $938.46 | $1,025.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $801.51 / $1,090.05 / $1,808.44
| Professional | | $801.51 | $1,090.05 | $1,808.44 |