- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $416.87 / $812.83
| Professional | | $354.81 | $416.87 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $549.54 / $758.58
| Professional | | $302.00 | $549.54 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $489.78 / $794.33
| Professional | | $380.19 | $489.78 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $501.19 / $707.95
| Professional | | $407.38 | $501.19 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $501.19 / $1,122.02
| Professional | | $354.81 | $501.19 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $501.19 / $794.33
| Professional | | $354.81 | $501.19 | $794.33 |