- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.08 / $274.31 / $1,107.27
| Professional | | $197.08 | $274.31 | $1,107.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.98 / $199.98 / $199.98
| Professional | | $199.98 | $199.98 | $199.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.04 / $529.52 / $621.78
| Professional | | $459.04 | $529.52 | $621.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.40 / $467.46 / $716.70
| Professional | | $380.40 | $467.46 | $716.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.98 / $514.08 / $701.26
| Professional | | $199.98 | $514.08 | $701.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $433.77 / $567.79 / $667.99
| Professional | | $433.77 | $567.79 | $667.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.70 / $334.66 / $750.03
| Professional | | $315.70 | $334.66 | $750.03 |