- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.29 / $202.23 / $308.16
| Professional | | $189.29 | $202.23 | $308.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.47 / $454.38 / $920.36
| Professional | | $385.47 | $454.38 | $920.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.76 / $337.45 / $574.42
| Professional | | $212.76 | $337.45 | $574.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.81 / $349.41 / $574.42
| Professional | | $224.81 | $349.41 | $574.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.33 / $360.79 / $1,048.84
| Professional | | $284.33 | $360.79 | $1,048.84 |