- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.42 / $305.63 / $420.49
| Professional | | $214.42 | $305.63 | $420.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.94 / $237.05 / $313.97
| Professional | | $217.94 | $237.05 | $313.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.75 / $329.10 / $634.32
| Professional | | $210.75 | $329.10 | $634.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.33 / $307.47 / $497.68
| Professional | | $161.33 | $307.47 | $497.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.25 / $268.88 / $384.35
| Professional | | $179.25 | $268.88 | $384.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.44 / $352.45 / $573.94
| Professional | | $294.44 | $352.45 | $573.94 |