- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.75 / $283.86 / $336.88
| Professional | | $232.75 | $283.86 | $336.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.86 / $291.81 / $515.48
| Professional | | $244.86 | $291.81 | $515.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.14 / $427.81 / $622.55
| Professional | | $327.14 | $427.81 | $622.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.04 / $361.03 / $677.38
| Professional | | $312.04 | $361.03 | $677.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.13 / $283.86 / $336.88
| Professional | | $232.13 | $283.86 | $336.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.15 / $317.76 / $559.88
| Professional | | $253.15 | $317.76 | $559.88 |