- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.06 / $368.25 / $394.94
| Professional | | $307.06 | $368.25 | $394.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.54 / $433.56 / $615.75
| Professional | | $278.54 | $433.56 | $615.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.18 / $470.40 / $537.60
| Professional | | $317.18 | $470.40 | $537.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $40.68 / $448.23
| Professional | | $32.34 | $40.68 | $448.23 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $528.59 / $528.59 / $528.59
| Facility | 26 | $528.59 | $528.59 | $528.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.14 / $411.93 / $585.55
| Professional | | $350.14 | $411.93 | $585.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.08 / $402.00 / $546.72
| Professional | | $291.08 | $402.00 | $546.72 |