- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.50 / $356.25 / $529.41
| Professional | | $307.50 | $356.25 | $529.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.42 / $878.08 / $878.08
| Professional | | $351.42 | $878.08 | $878.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $484.38 / $524.50 / $524.50
| Professional | | $484.38 | $524.50 | $524.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.10 / $433.63 / $634.71
| Professional | | $342.10 | $433.63 | $634.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.93 / $426.31 / $536.05
| Professional | | $332.93 | $426.31 | $536.05 |