- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.72 / $320.45 / $320.45
| Professional | | $277.72 | $320.45 | $320.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.81 / $384.53 / $438.36
| Professional | | $341.81 | $384.53 | $438.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.45 / $226.45 / $249.95
| Professional | | $226.45 | $226.45 | $249.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.26 / $512.71 / $746.00
| Professional | | $427.26 | $512.71 | $746.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.45 / $192.27 / $384.53
| Professional | | $179.45 | $192.27 | $384.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.63 / $213.63 / $213.63
| Professional | | $213.63 | $213.63 | $213.63 |