- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.89 / $323.27 / $527.09
| Professional | | $282.89 | $323.27 | $527.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.04 / $368.04 / $450.65
| Professional | | $368.04 | $368.04 | $450.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.96 / $436.96 / $436.96
| Facility | | $436.96 | $436.96 | $436.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.98 / $318.98 / $436.96
| Professional | | $318.98 | $318.98 | $436.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.47 / $659.24 / $949.31
| Professional | | $461.47 | $659.24 | $949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.95 / $345.33 / $521.53
| Professional | | $296.95 | $345.33 | $521.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.46 / $367.46 / $461.47
| Professional | | $367.46 | $367.46 | $461.47 |