- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.35 / $296.39 / $457.98
| Professional | | $209.35 | $296.39 | $457.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.77 / $248.63 / $285.92
| Professional | | $231.77 | $248.63 | $285.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.54 / $333.43 / $657.87
| Professional | | $204.54 | $333.43 | $657.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.98 / $399.28 / $857.11
| Professional | | $331.98 | $399.28 | $857.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.67 / $403.55 / $722.77
| Professional | | $323.67 | $403.55 | $722.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.47 / $347.20 / $399.28
| Professional | | $238.47 | $347.20 | $399.28 |