- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $551.37 / $625.29 / $812.03
| Professional | | $551.37 | $625.29 | $812.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.36 / $681.37 / $1,026.27
| Professional | | $557.36 | $681.37 | $1,026.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $690.38 / $812.03 / $1,129.75
| Professional | | $690.38 | $812.03 | $1,129.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.33 / $650.45 / $1,012.10
| Professional | | $584.33 | $650.45 | $1,012.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $551.37 / $625.29 / $812.03
| Professional | | $551.37 | $625.29 | $812.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.95 / $781.96 / $943.74
| Professional | | $603.95 | $781.96 | $943.74 |