- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.15 / $286.74 / $401.08
| Professional | | $209.15 | $286.74 | $401.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.89 / $279.89 / $279.89
| Professional | | $279.89 | $279.89 | $279.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.58 / $306.58 / $306.58
| Facility | | $306.58 | $306.58 | $306.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.58 / $306.58 / $306.58
| Professional | | $306.58 | $306.58 | $306.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.62 / $267.62 / $376.88
| Facility | | $267.62 | $267.62 | $376.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.48 / $267.62 / $330.59
| Professional | | $227.48 | $267.62 | $330.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.49 / $193.68 / $382.10
| Professional | | $127.49 | $193.68 | $382.10 |