- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.47 / $332.49 / $575.89
| Professional | | $226.47 | $332.49 | $575.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.49 / $382.26 / $571.04
| Professional | | $267.49 | $382.26 | $571.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.98 / $386.29 / $677.70
| Professional | | $262.98 | $386.29 | $677.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.73 / $486.43 / $1,492.25
| Professional | | $302.73 | $486.43 | $1,492.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.22 / $291.73 / $454.19
| Professional | | $283.22 | $291.73 | $454.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $513.59
| Professional | | $32.34 | $32.34 | $513.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.98 / $460.25 / $768.84
| Professional | | $335.98 | $460.25 | $768.84 |