- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $356.77 / $421.79
| Professional | | $331.13 | $356.77 | $421.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.17 / $558.95 / $1,174.07
| Professional | | $474.17 | $558.95 | $1,174.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.81 / $440.33 / $729.69
| Professional | | $343.81 | $440.33 | $729.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.99 / $445.03 / $729.69
| Professional | | $336.99 | $445.03 | $729.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.85 / $458.30 / $1,332.32
| Professional | | $405.85 | $458.30 | $1,332.32 |