- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.49 / $344.71 / $601.83
| Professional | | $255.49 | $344.71 | $601.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.38 / $444.85 / $665.65
| Professional | | $289.38 | $444.85 | $665.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $63.97 / $533.08
| Professional | | $32.34 | $63.97 | $533.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.73 / $480.75 / $753.65
| Professional | | $319.73 | $480.75 | $753.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.31 / $560.05 / $900.73
| Professional | | $404.31 | $560.05 | $900.73 |