- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.60 / $287.61 / $419.19
| Professional | | $195.60 | $287.61 | $419.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.28 / $281.01 / $465.87
| Professional | | $50.28 | $281.01 | $465.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.13 / $240.04 / $592.07
| Professional | | $185.13 | $240.04 | $592.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.60 / $340.89 / $485.53
| Professional | | $254.60 | $340.89 | $485.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.13 / $234.14 / $347.06
| Professional | | $32.13 | $234.14 | $347.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.17 / $376.22 / $472.85
| Professional | | $320.17 | $376.22 | $472.85 |