- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.08 / $423.52 / $606.59
| Professional | | $319.08 | $423.52 | $606.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.25 / $434.41 / $623.14
| Professional | | $369.25 | $434.41 | $623.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.68 / $640.67 / $897.60
| Professional | | $408.68 | $640.67 | $897.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.80 / $573.37 / $1,017.67
| Professional | | $418.80 | $573.37 | $1,017.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.08 / $423.52 / $606.59
| Professional | | $319.08 | $423.52 | $606.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.80 / $640.37 / $1,017.67
| Professional | | $418.80 | $640.37 | $1,017.67 |