- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.92 / $411.23 / $632.28
| Professional | | $276.92 | $411.23 | $632.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.83 / $475.91 / $615.75
| Professional | | $321.83 | $475.91 | $615.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.02 / $535.98 / $846.66
| Professional | | $364.02 | $535.98 | $846.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.48 / $472.38 / $735.02
| Professional | | $347.48 | $472.38 | $735.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.92 / $411.23 / $632.28
| Professional | | $276.92 | $411.23 | $632.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.92 / $602.55 / $775.36
| Professional | | $438.92 | $602.55 | $775.36 |