- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.23 / $608.72 / $2,343.35
| Facility | | $543.23 | $608.72 | $2,343.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.89 / $572.28 / $741.84
| Professional | | $529.89 | $572.28 | $741.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.35 / $620.67 / $653.35
| Facility | | $555.35 | $620.67 | $653.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.69 / $550.69 / $550.69
| Professional | | $550.69 | $550.69 | $550.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.90 / $499.90 / $529.89
| Facility | | $499.90 | $499.90 | $529.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.89 / $529.89 / $529.89
| Professional | | $529.89 | $529.89 | $529.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.58 / $599.73 / $745.61
| Facility | | $532.58 | $599.73 | $745.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.57 / $532.58 / $587.76
| Professional | | $524.57 | $532.58 | $587.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.89 / $529.89 / $596.50
| Professional | | $529.89 | $529.89 | $596.50 |