- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.31 / $327.83 / $500.44
| Professional | | $304.31 | $327.83 | $500.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.65 / $421.27 / $608.51
| Professional | | $336.65 | $421.27 | $608.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.43 / $517.17 / $801.45
| Professional | | $391.43 | $517.17 | $801.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.06 / $455.93 / $699.42
| Professional | | $394.06 | $455.93 | $699.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.54 / $327.83 / $500.44
| Professional | | $285.54 | $327.83 | $500.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.98 / $530.36 / $731.93
| Professional | | $393.98 | $530.36 | $731.93 |