- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.97 / $401.04 / $545.35
| Professional | | $327.97 | $401.04 | $545.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.69 / $535.86 / $764.64
| Professional | | $419.69 | $535.86 | $764.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $452.66 / $630.17 / $905.41
| Professional | | $452.66 | $630.17 | $905.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.54 / $612.88 / $996.46
| Professional | | $511.54 | $612.88 | $996.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.97 / $418.37 / $545.35
| Professional | | $327.97 | $418.37 | $545.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.37 / $579.28 / $901.72
| Professional | | $413.37 | $579.28 | $901.72 |