- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.67 / $403.68 / $673.74
| Professional | | $289.67 | $403.68 | $673.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.55 / $617.72 / $1,461.84
| Professional | | $327.55 | $617.72 | $1,461.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.93 / $642.57 / $790.32
| Professional | | $488.93 | $642.57 | $790.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.32 / $511.41 / $817.75
| Professional | | $307.32 | $511.41 | $817.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.64 / $476.86 / $1,065.35
| Professional | | $321.64 | $476.86 | $1,065.35 |