- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.21 / $203.67 / $346.81
| Professional | | $180.21 | $203.67 | $346.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.20 / $226.91 / $417.91
| Professional | | $217.20 | $226.91 | $417.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.67 / $264.67 / $264.67
| Facility | | $264.67 | $264.67 | $264.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.55 / $341.68 / $489.82
| Professional | | $220.55 | $341.68 | $489.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $355.29
| Professional | | $32.34 | $32.34 | $355.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.38 / $250.67 / $407.62
| Facility | | $184.38 | $250.67 | $407.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.63 / $394.47 / $595.08
| Professional | | $241.63 | $394.47 | $595.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.64 / $343.73 / $490.61
| Professional | | $242.64 | $343.73 | $490.61 |