- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.36 / $337.36 / $719.28
| Professional | | $337.36 | $337.36 | $719.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.45 / $340.97 / $340.97
| Professional | | $313.45 | $340.97 | $340.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.82 / $459.12 / $605.88
| Professional | | $362.82 | $459.12 | $605.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.79 / $427.31 / $655.52
| Professional | | $331.79 | $427.31 | $655.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.36 / $337.36 / $719.28
| Professional | | $337.36 | $337.36 | $719.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.98 / $387.02 / $571.40
| Professional | | $346.98 | $387.02 | $571.40 |