- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.04 / $470.06 / $709.87
| Professional | | $86.04 | $470.06 | $709.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.36 / $400.03 / $860.19
| Professional | | $339.36 | $400.03 | $860.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.35 / $277.51 / $860.19
| Professional | | $124.35 | $277.51 | $860.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.21 / $348.08 / $860.19
| Professional | | $147.21 | $348.08 | $860.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.77 / $853.17 / $1,055.79
| Professional | | $300.77 | $853.17 | $1,055.79 |