- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.57 / $530.61 / $932.75
| Professional | | $320.57 | $530.61 | $932.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.76 / $728.12 / $1,183.43
| Professional | | $271.76 | $728.12 | $1,183.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.06 / $597.58 / $892.82
| Professional | | $342.06 | $597.58 | $892.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.83 / $326.83 / $326.83
| Professional | | $326.83 | $326.83 | $326.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.82 / $285.06 / $386.37
| Professional | | $31.82 | $285.06 | $386.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.83 / $475.04 / $1,052.50
| Professional | | $294.83 | $475.04 | $1,052.50 |