- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.82 / $413.50 / $731.76
| Professional | | $316.82 | $413.50 | $731.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.97 / $453.16 / $851.93
| Professional | | $411.97 | $453.16 | $851.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.46 / $793.91 / $1,440.81
| Professional | | $431.46 | $793.91 | $1,440.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.86 / $1,105.52 / $1,774.80
| Professional | | $535.86 | $1,105.52 | $1,774.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.82 / $498.03 / $731.76
| Professional | | $316.82 | $498.03 | $731.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $536.21 / $950.35 / $1,345.06
| Professional | | $536.21 | $950.35 | $1,345.06 |