- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.44 / $359.57 / $772.54
| Professional | | $317.44 | $359.57 | $772.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.99 / $503.22 / $807.18
| Professional | | $298.99 | $503.22 | $807.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.06 / $526.78 / $992.38
| Professional | | $312.06 | $526.78 | $992.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.62 / $570.63 / $988.37
| Professional | | $304.62 | $570.63 | $988.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.44 / $359.57 / $772.54
| Professional | | $317.44 | $359.57 | $772.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $504.65 / $742.28 / $1,091.81
| Professional | | $504.65 | $742.28 | $1,091.81 |