- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.32 / $174.89 / $180.04
| Professional | | $143.32 | $174.89 | $180.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.74 / $373.63 / $411.16
| Professional | | $310.74 | $373.63 | $411.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.35 / $309.58 / $445.51
| Professional | | $220.35 | $309.58 | $445.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.87 / $360.08 / $1,419.41
| Professional | | $199.87 | $360.08 | $1,419.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.13 / $327.06 / $452.75
| Professional | | $198.13 | $327.06 | $452.75 |