- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.37 / $392.98 / $494.68
| Professional | | $331.37 | $392.98 | $494.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $384.75 / $495.70 / $694.99
| Professional | | $384.75 | $495.70 | $694.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.75 / $566.59 / $827.97
| Professional | | $392.75 | $566.59 | $827.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.21 / $566.95 / $919.65
| Professional | | $473.21 | $566.95 | $919.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.43 / $421.99 / $494.68
| Professional | | $332.43 | $421.99 | $494.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.67 / $516.42 / $964.84
| Professional | | $362.67 | $516.42 | $964.84 |