- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $532.91 / $550.42 / $679.13
| Professional | | $532.91 | $550.42 | $679.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.14 / $82.73 / $528.16
| Facility | | $57.14 | $82.73 | $528.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.53 / $72.39 / $568.79
| Professional | | $61.53 | $72.39 | $568.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.72 / $422.72 / $977.54
| Facility | | $422.72 | $422.72 | $977.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.20 / $422.72 / $4,087.99
| Professional | | $72.20 | $422.72 | $4,087.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.80 / $420.97 / $704.15
| Professional | | $318.80 | $420.97 | $704.15 |