- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.66 / $609.91 / $724.36
| Professional | | $481.66 | $609.91 | $724.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $606.07 / $784.33 / $1,120.29
| Professional | | $606.07 | $784.33 | $1,120.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $600.54 / $870.75 / $1,250.32
| Professional | | $600.54 | $870.75 | $1,250.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $731.66 / $846.53 / $1,298.61
| Professional | | $731.66 | $846.53 | $1,298.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.66 / $651.38 / $724.36
| Professional | | $481.66 | $651.38 | $724.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $543.19 / $760.47 / $1,165.49
| Professional | | $543.19 | $760.47 | $1,165.49 |