- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.31 / $350.97 / $498.33
| Professional | | $278.31 | $350.97 | $498.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.42 / $349.91 / $499.15
| Professional | | $297.42 | $349.91 | $499.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.75 / $511.82 / $728.63
| Professional | | $343.75 | $511.82 | $728.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.94 / $465.37 / $825.99
| Professional | | $328.94 | $465.37 | $825.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.31 / $350.97 / $498.33
| Professional | | $278.31 | $350.97 | $498.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.16 / $521.24 / $723.94
| Professional | | $326.16 | $521.24 | $723.94 |