- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.97 / $456.58 / $518.49
| Professional | | $327.97 | $456.58 | $518.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.20 / $662.72 / $1,596.61
| Professional | | $562.20 | $662.72 | $1,596.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.94 / $677.19 / $970.07
| Professional | | $434.94 | $677.19 | $970.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.39 / $641.66 / $970.07
| Professional | | $529.39 | $641.66 | $970.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $490.11 / $609.28 / $1,771.22
| Professional | | $490.11 | $609.28 | $1,771.22 |