- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.99 / $412.18 / $587.12
| Professional | | $278.99 | $412.18 | $587.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.07 / $709.71 / $1,795.91
| Professional | | $602.07 | $709.71 | $1,795.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $433.07 / $658.01 / $1,133.81
| Professional | | $433.07 | $658.01 | $1,133.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.88 / $661.89 / $1,133.81
| Professional | | $446.88 | $661.89 | $1,133.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.26 / $712.12 / $2,070.19
| Professional | | $524.26 | $712.12 | $2,070.19 |