- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.71 / $215.75 / $329.99
| Professional | | $172.71 | $215.75 | $329.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.69 / $373.12 / $766.30
| Professional | | $173.69 | $373.12 | $766.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.86 / $414.90 / $642.79
| Professional | | $238.86 | $414.90 | $642.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.40 / $282.85 / $478.89
| Professional | | $204.40 | $282.85 | $478.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.64 / $336.64 / $336.64
| Professional | | $336.64 | $336.64 | $336.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.20 / $303.67 / $626.26
| Professional | | $183.20 | $303.67 | $626.26 |