- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.98 / $394.07 / $399.77
| Professional | | $326.98 | $394.07 | $399.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.53 / $445.48 / $695.60
| Professional | | $340.53 | $445.48 | $695.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.05 / $379.05 / $456.00
| Facility | | $379.05 | $379.05 | $456.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.23 / $484.17 / $717.78
| Professional | | $324.23 | $484.17 | $717.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.34 / $485.97 / $760.47
| Professional | | $377.34 | $485.97 | $760.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.98 / $394.07 / $797.78
| Professional | | $326.98 | $394.07 | $797.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.33 / $449.57 / $664.63
| Professional | | $317.33 | $449.57 | $664.63 |