- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.56 / $437.94 / $541.62
| Professional | | $267.56 | $437.94 | $541.62 |
- Facility/Professional
- Professional
- Modifier
- 54
- Low / Median / High Price
- $359.26 / $374.51 / $397.29
| Professional | 54 | $359.26 | $374.51 | $397.29 |
- Facility/Professional
- Professional
- Modifier
- 55
- Low / Median / High Price
- $71.84 / $74.90 / $79.45
| Professional | 55 | $71.84 | $74.90 | $79.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.79 / $398.98 / $504.68
| Professional | | $308.79 | $398.98 | $504.68 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $463.19 / $598.47 / $753.12
| Professional | 50 | $463.19 | $598.47 | $753.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $712.05 / $712.05 / $712.05
| Facility | | $712.05 | $712.05 | $712.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.69 / $596.82 / $672.60
| Professional | | $409.69 | $596.82 | $672.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.87 / $440.67 / $676.01
| Professional | | $380.87 | $440.67 | $676.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.14 / $437.94 / $733.57
| Professional | | $269.14 | $437.94 | $733.57 |
- Facility/Professional
- Professional
- Modifier
- 54
- Low / Median / High Price
- $359.26 / $359.26 / $383.58
| Professional | 54 | $359.26 | $359.26 | $383.58 |
- Facility/Professional
- Professional
- Modifier
- 55
- Low / Median / High Price
- $71.84 / $71.84 / $76.72
| Professional | 55 | $71.84 | $71.84 | $76.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.86 / $455.63 / $603.34
| Professional | | $269.86 | $455.63 | $603.34 |