- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.11 / $342.56 / $352.78
| Professional | | $300.11 | $342.56 | $352.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.89 / $372.93 / $471.60
| Professional | | $357.89 | $372.93 | $471.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.00 / $234.00 / $234.00
| Facility | | $234.00 | $234.00 | $234.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.90 / $489.07 / $966.09
| Professional | | $198.90 | $489.07 | $966.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.94 / $437.94 / $437.94
| Professional | | $437.94 | $437.94 | $437.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.46 / $291.29 / $417.92
| Professional | | $197.46 | $291.29 | $417.92 |