- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.99 / $336.66 / $406.05
| Professional | | $308.99 | $336.66 | $406.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.84 / $441.86 / $1,264.04
| Professional | | $374.84 | $441.86 | $1,264.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.65 / $514.14 / $755.42
| Professional | | $331.65 | $514.14 | $755.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.83 / $455.81 / $755.42
| Professional | | $344.83 | $455.81 | $755.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.41 / $466.75 / $1,379.33
| Professional | | $316.41 | $466.75 | $1,379.33 |