- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $464.72 / $589.29 / $698.94
| Professional | | $464.72 | $589.29 | $698.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $585.24 / $757.37 / $1,082.42
| Professional | | $585.24 | $757.37 | $1,082.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $580.65 / $838.73 / $1,207.53
| Professional | | $580.65 | $838.73 | $1,207.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $706.92 / $817.91 / $1,254.71
| Professional | | $706.92 | $817.91 | $1,254.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $464.72 / $597.60 / $698.94
| Professional | | $464.72 | $597.60 | $698.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.80 / $726.95 / $1,126.69
| Professional | | $478.80 | $726.95 | $1,126.69 |