- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.97 / $521.76 / $525.32
| Professional | | $466.97 | $521.76 | $525.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.03 / $520.70 / $595.16
| Professional | | $507.03 | $520.70 | $595.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.12 / $515.84 / $1,085.91
| Professional | | $401.12 | $515.84 | $1,085.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.83 / $563.51 / $923.28
| Professional | | $436.83 | $563.51 | $923.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.22 / $481.96 / $871.14
| Professional | | $364.22 | $481.96 | $871.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.51 / $368.51 / $614.33
| Professional | | $368.51 | $368.51 | $614.33 |