- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $295.12 / $575.44
| Professional | | $194.98 | $295.12 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $354.81 / $562.34
| Professional | | $223.87 | $354.81 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $331.13 / $537.03
| Professional | | $218.78 | $331.13 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $316.23 / $724.44
| Professional | | $181.97 | $316.23 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $302.00 / $316.23
| Professional | | $181.97 | $302.00 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $346.74 / $588.84
| Professional | | $213.80 | $346.74 | $588.84 |