- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.58 / $267.13 / $275.77
| Professional | | $191.58 | $267.13 | $275.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.96 / $233.17 / $350.32
| Professional | | $190.96 | $233.17 | $350.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.19 / $275.77 / $385.18
| Professional | | $232.19 | $275.77 | $385.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.96 / $222.59 / $346.35
| Professional | | $199.96 | $222.59 | $346.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.58 / $267.13 / $275.77
| Professional | | $191.58 | $267.13 | $275.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.72 / $273.32 / $346.15
| Professional | | $218.72 | $273.32 | $346.15 |