- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.28 / $314.98 / $490.22
| Professional | | $225.28 | $314.98 | $490.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $536.66 / $632.62 / $1,502.42
| Professional | | $536.66 | $632.62 | $1,502.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.46 / $543.78 / $960.96
| Professional | | $351.46 | $543.78 | $960.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.12 / $549.09 / $960.96
| Professional | | $361.12 | $549.09 | $960.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.43 / $603.57 / $1,754.62
| Professional | | $432.43 | $603.57 | $1,754.62 |