- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $388.58 / $448.10 / $528.69
| Professional | | $388.58 | $448.10 | $528.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.99 / $573.28 / $823.02
| Professional | | $442.99 | $573.28 | $823.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.94 / $641.01 / $915.84
| Professional | | $442.94 | $641.01 | $915.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.51 / $621.90 / $954.03
| Professional | | $537.51 | $621.90 | $954.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.04 / $473.56 / $528.69
| Professional | | $351.04 | $473.56 | $528.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.27 / $577.49 / $858.82
| Professional | | $398.27 | $577.49 | $858.82 |