- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.93 / $411.25 / $543.45
| Professional | | $274.93 | $411.25 | $543.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.42 / $432.13 / $580.35
| Professional | | $218.42 | $432.13 | $580.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.12 / $529.84 / $695.44
| Professional | | $437.12 | $529.84 | $695.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $563.22
| Professional | | $32.34 | $32.34 | $563.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.76 / $506.16 / $667.46
| Professional | | $411.76 | $506.16 | $667.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.75 / $471.66 / $617.16
| Professional | | $372.75 | $471.66 | $617.16 |