- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.08 / $388.45 / $534.99
| Professional | | $294.08 | $388.45 | $534.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.14 / $438.74 / $726.94
| Professional | | $297.14 | $438.74 | $726.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.52 / $347.72 / $545.15
| Professional | | $241.52 | $347.72 | $545.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.26 / $290.71 / $541.63
| Professional | | $33.26 | $290.71 | $541.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.23 / $435.34 / $770.11
| Professional | | $335.23 | $435.34 | $770.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.92 / $395.88 / $395.88
| Professional | | $300.92 | $395.88 | $395.88 |