- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.97 / $477.95 / $527.94
| Professional | | $361.97 | $477.95 | $527.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.64 / $505.81 / $740.88
| Professional | | $419.64 | $505.81 | $740.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.68 / $392.68 / $392.68
| Facility | | $392.68 | $392.68 | $392.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.03 / $527.94 / $750.52
| Professional | | $351.03 | $527.94 | $750.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.82 / $487.88 / $915.38
| Professional | | $378.82 | $487.88 | $915.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.97 / $477.95 / $527.94
| Professional | | $361.97 | $477.95 | $527.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.47 / $489.46 / $750.45
| Professional | | $345.47 | $489.46 | $750.45 |