- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $508.97 / $1,057.17
| Professional | | $467.74 | $508.97 | $1,057.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.75 / $519.88 / $594.22
| Professional | | $445.75 | $519.88 | $594.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.59 / $522.28 / $1,044.64
| Professional | | $387.59 | $522.28 | $1,044.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.70 / $547.86 / $906.08
| Professional | | $424.70 | $547.86 | $906.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.42 / $471.19 / $797.82
| Professional | | $360.42 | $471.19 | $797.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.21 / $361.21 / $595.28
| Professional | | $361.21 | $361.21 | $595.28 |