- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.19 / $257.94 / $376.87
| Professional | | $184.19 | $257.94 | $376.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.96 / $311.52 / $520.10
| Professional | | $192.96 | $311.52 | $520.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.54 / $215.92 / $337.08
| Professional | | $120.54 | $215.92 | $337.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.92 / $230.60 / $361.06
| Professional | | $31.92 | $230.60 | $361.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.54 / $309.29 / $575.17
| Professional | | $218.54 | $309.29 | $575.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.66 / $229.54 / $229.54
| Professional | | $151.66 | $229.54 | $229.54 |