- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.69 / $263.35 / $279.58
| Professional | | $260.69 | $263.35 | $279.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.94 / $114.94 / $114.94
| Professional | | $114.94 | $114.94 | $114.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.00 / $174.89 / $239.46
| Facility | | $136.00 | $174.89 | $239.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.94 / $279.58 / $303.89
| Professional | | $114.94 | $279.58 | $303.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.98 / $119.47 / $171.39
| Professional | | $107.98 | $119.47 | $171.39 |