- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.70 / $399.72 / $683.64
| Professional | | $291.70 | $399.72 | $683.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.44 / $600.38 / $997.69
| Professional | | $297.44 | $600.38 | $997.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.37 / $516.44 / $1,191.61
| Professional | | $266.37 | $516.44 | $1,191.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.11 / $662.79 / $4,446.43
| Professional | | $332.11 | $662.79 | $4,446.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.52 / $491.19 / $1,002.10
| Professional | | $321.52 | $491.19 | $1,002.10 |