- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.47 / $403.14 / $441.40
| Professional | | $349.47 | $403.14 | $441.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $587.66 / $851.75 / $1,194.23
| Professional | | $587.66 | $851.75 | $1,194.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $464.34 / $669.96 / $1,406.21
| Professional | | $464.34 | $669.96 | $1,406.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.40 / $727.65 / $1,362.38
| Professional | | $441.40 | $727.65 | $1,362.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.03 / $466.33 / $829.12
| Professional | | $329.03 | $466.33 | $829.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.89 / $205.58 / $261.64
| Professional | | $186.89 | $205.58 | $261.64 |