- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.99 / $301.10 / $1,011.44
| Professional | | $188.99 | $301.10 | $1,011.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.06 / $437.22 / $561.51
| Professional | | $271.06 | $437.22 | $561.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.44 / $435.02 / $497.86
| Professional | | $302.44 | $435.02 | $497.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.41 / $338.56 / $595.19
| Professional | | $299.41 | $338.56 | $595.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.97 / $460.00 / $574.94
| Professional | | $327.97 | $460.00 | $574.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.49 / $468.51 / $598.98
| Professional | | $355.49 | $468.51 | $598.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.67 / $431.36 / $614.94
| Professional | | $285.67 | $431.36 | $614.94 |