- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.17 / $331.14 / $884.30
| Professional | | $168.17 | $331.14 | $884.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $646.86 / $748.58 / $1,220.19
| Professional | | $646.86 | $748.58 | $1,220.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.94 / $335.38 / $574.12
| Professional | | $231.94 | $335.38 | $574.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.41 / $339.57 / $574.12
| Professional | | $162.41 | $339.57 | $574.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.21 / $451.95 / $1,369.68
| Professional | | $382.21 | $451.95 | $1,369.68 |