- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.84 / $211.94 / $366.56
| Professional | | $139.84 | $211.94 | $366.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.32 / $246.01 / $312.01
| Professional | | $174.32 | $246.01 | $312.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.85 / $301.01 / $364.86
| Professional | | $250.85 | $301.01 | $364.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $260.48 / $327.70
| Professional | | $32.34 | $260.48 | $327.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.73 / $314.98 / $372.33
| Professional | | $261.73 | $314.98 | $372.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.80 / $265.14 / $362.11
| Professional | | $193.80 | $265.14 | $362.11 |