- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.36 / $403.98 / $493.91
| Professional | | $385.36 | $403.98 | $493.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.39 / $319.08 / $410.03
| Professional | | $258.39 | $319.08 | $410.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.64 / $531.64 / $531.64
| Facility | | $531.64 | $531.64 | $531.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.07 / $476.20 / $629.71
| Professional | | $377.07 | $476.20 | $629.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.62 / $376.34 / $585.58
| Professional | | $304.62 | $376.34 | $585.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.31 / $385.36 / $476.61
| Professional | | $235.31 | $385.36 | $476.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.25 / $427.62 / $563.51
| Professional | | $297.25 | $427.62 | $563.51 |