- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.97 / $280.49 / $319.63
| Professional | | $213.97 | $280.49 | $319.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.61 / $328.61 / $328.61
| Professional | | $328.61 | $328.61 | $328.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.74 / $354.06 / $354.06
| Professional | | $325.74 | $354.06 | $354.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.17 / $243.17 / $385.50
| Facility | | $243.17 | $243.17 | $385.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.69 / $243.17 / $436.13
| Professional | | $206.69 | $243.17 | $436.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.46 / $217.15 / $326.14
| Professional | | $130.46 | $217.15 | $326.14 |