- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.18 / $264.83 / $369.65
| Professional | | $225.18 | $264.83 | $369.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.47 / $366.85 / $512.76
| Professional | | $283.47 | $366.85 | $512.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.76 / $433.76 / $613.88
| Professional | | $304.76 | $433.76 | $613.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.37 / $419.78 / $680.41
| Professional | | $350.37 | $419.78 | $680.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.65 / $324.91 / $444.65
| Professional | | $236.65 | $324.91 | $444.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.93 / $398.58 / $616.54
| Professional | | $280.93 | $398.58 | $616.54 |