- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.78 / $266.76 / $346.96
| Professional | | $235.78 | $266.76 | $346.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.48 / $267.24 / $352.90
| Professional | | $222.48 | $267.24 | $352.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.71 / $319.92 / $458.57
| Professional | | $239.71 | $319.92 | $458.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.24 / $267.54 / $413.06
| Professional | | $231.24 | $267.54 | $413.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.78 / $266.76 / $399.94
| Professional | | $235.78 | $266.76 | $399.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.64 / $291.35 / $427.38
| Professional | | $208.64 | $291.35 | $427.38 |