- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.87 / $332.83 / $366.78
| Professional | | $296.87 | $332.83 | $366.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.27 / $365.03 / $536.66
| Professional | | $310.27 | $365.03 | $536.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.36 / $511.24 / $657.67
| Professional | | $356.36 | $511.24 | $657.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.07 / $393.46 / $738.22
| Professional | | $340.07 | $393.46 | $738.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.87 / $341.41 / $580.14
| Professional | | $296.87 | $341.41 | $580.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.14 / $453.85 / $577.41
| Professional | | $295.14 | $453.85 | $577.41 |