- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.01 / $450.50 / $520.87
| Professional | | $353.01 | $450.50 | $520.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.46 / $576.48 / $827.44
| Professional | | $445.46 | $576.48 | $827.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.27 / $644.40 / $920.84
| Professional | | $445.27 | $644.40 | $920.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.39 / $625.23 / $959.14
| Professional | | $540.39 | $625.23 | $959.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.01 / $468.13 / $520.87
| Professional | | $353.01 | $468.13 | $520.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.20 / $556.46 / $863.35
| Professional | | $349.20 | $556.46 | $863.35 |