- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $223.87 / $512.86
| Professional | | $154.88 | $223.87 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $354.81 / $575.44
| Professional | | $199.53 | $354.81 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $389.05 / $562.34
| Professional | | $275.42 | $389.05 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $363.08 / $537.03
| Professional | | $257.04 | $363.08 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $371.54 / $562.34
| Professional | | $79.43 | $371.54 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $407.38 / $575.44
| Professional | | $295.12 | $407.38 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $354.81 / $549.54
| Professional | | $229.09 | $354.81 | $549.54 |