- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.14 / $621.82 / $724.66
| Professional | | $500.14 | $621.82 | $724.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.41 / $734.92 / $1,048.51
| Professional | | $576.41 | $734.92 | $1,048.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $615.27 / $862.70 / $1,211.02
| Professional | | $615.27 | $862.70 | $1,211.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $701.56 / $840.54 / $1,320.56
| Professional | | $701.56 | $840.54 | $1,320.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $519.04 / $683.51 / $1,051.42
| Professional | | $519.04 | $683.51 | $1,051.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.73 / $769.82 / $1,190.35
| Professional | | $550.73 | $769.82 | $1,190.35 |