- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $269.15 / $691.83
| Professional | | $147.91 | $269.15 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $263.03 / $407.38
| Professional | | $186.21 | $263.03 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $407.38 / $741.31
| Professional | | $239.88 | $407.38 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $346.74 / $346.74
| Professional | | $331.13 | $346.74 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $281.84 / $478.63
| Professional | | $190.55 | $281.84 | $478.63 |