- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.47 / $304.47 / $514.13
| Professional | | $208.47 | $304.47 | $514.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.55 / $227.73 / $260.29
| Professional | | $202.55 | $227.73 | $260.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.68 / $337.98 / $741.36
| Professional | | $209.68 | $337.98 | $741.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.43 / $399.16 / $729.95
| Professional | | $309.43 | $399.16 | $729.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.05 / $398.82 / $721.45
| Professional | | $279.05 | $398.82 | $721.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.33 / $355.84 / $440.10
| Professional | | $275.33 | $355.84 | $440.10 |