- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.50 / $274.99 / $317.51
| Professional | | $89.50 | $274.99 | $317.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.94 / $224.40 / $415.00
| Professional | | $82.94 | $224.40 | $415.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.94 / $291.89 / $562.60
| Professional | | $118.94 | $291.89 | $562.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.20 / $256.70 / $382.50
| Professional | | $248.20 | $256.70 | $382.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.87 / $336.69 / $516.02
| Professional | | $246.87 | $336.69 | $516.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.18 / $368.37 / $720.70
| Professional | | $269.18 | $368.37 | $720.70 |