- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.14 / $383.20 / $499.63
| Professional | | $356.14 | $383.20 | $499.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.04 / $520.28 / $743.50
| Professional | | $402.04 | $520.28 | $743.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.01 / $599.54 / $841.88
| Professional | | $392.01 | $599.54 | $841.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.57 / $561.79 / $861.84
| Professional | | $485.57 | $561.79 | $861.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.14 / $383.20 / $499.63
| Professional | | $356.14 | $383.20 | $499.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.72 / $540.71 / $785.34
| Professional | | $379.72 | $540.71 | $785.34 |