- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $484.09 / $618.91 / $736.02
| Professional | | $484.09 | $618.91 | $736.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $611.37 / $791.18 / $1,123.45
| Professional | | $611.37 | $791.18 | $1,123.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.65 / $883.22 / $1,265.98
| Professional | | $602.65 | $883.22 | $1,265.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $733.72 / $848.91 / $1,302.28
| Professional | | $733.72 | $848.91 | $1,302.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $484.09 / $649.23 / $736.02
| Professional | | $484.09 | $649.23 | $736.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.72 / $755.18 / $1,172.39
| Professional | | $502.72 | $755.18 | $1,172.39 |