- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.80 / $408.80 / $553.35
| Professional | | $299.80 | $408.80 | $553.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.49 / $485.87 / $738.82
| Professional | | $342.49 | $485.87 | $738.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.47 / $522.47 / $699.00
| Facility | | $522.47 | $522.47 | $699.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.92 / $582.62 / $1,027.96
| Professional | | $344.92 | $582.62 | $1,027.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.59 / $579.97 / $1,029.39
| Professional | | $391.59 | $579.97 | $1,029.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.80 / $408.80 / $755.98
| Professional | | $299.80 | $408.80 | $755.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $395.25 / $573.99 / $951.62
| Professional | | $395.25 | $573.99 | $951.62 |