- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.87 / $214.61 / $348.07
| Professional | | $156.87 | $214.61 | $348.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.47 / $152.47 / $326.52
| Professional | | $152.47 | $152.47 | $326.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.67 / $326.52 / $388.13
| Facility | | $194.67 | $326.52 | $388.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.32 / $293.87 / $909.28
| Professional | | $140.32 | $293.87 | $909.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.62 / $209.71 / $341.81
| Facility | | $172.62 | $209.71 | $341.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.49 / $326.52 / $499.84
| Professional | | $204.49 | $326.52 | $499.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.42 / $343.14 / $409.36
| Professional | | $231.42 | $343.14 | $409.36 |