- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.90 / $314.02 / $346.01
| Professional | | $254.90 | $314.02 | $346.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $824.85 / $1,114.07 / $1,318.92
| Facility | | $824.85 | $1,114.07 | $1,318.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.60 / $306.58 / $512.76
| Professional | | $260.60 | $306.58 | $512.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.46 / $373.35 / $373.35
| Facility | | $337.46 | $373.35 | $373.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.55 / $373.35 / $373.35
| Professional | | $272.55 | $373.35 | $373.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.89 / $291.05 / $485.09
| Professional | | $227.89 | $291.05 | $485.09 |