- Facility/Professional
- Professional
- Modifier
- AA
- Low / Median / High Price
- $524.81 / $741.31 / $1,174.90
| Professional | AA | $524.81 | $741.31 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Low / Median / High Price
- $602.56 / $741.31 / $933.25
| Professional | QZ | $602.56 | $741.31 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- AA
- Low / Median / High Price
- $173.78 / $524.81 / $912.01
| Professional | AA | $173.78 | $524.81 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- QZ
- Low / Median / High Price
- $154.88 / $295.12 / $812.83
| Professional | QZ | $154.88 | $295.12 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- AA
- Low / Median / High Price
- $416.87 / $416.87 / $524.81
| Professional | AA | $416.87 | $416.87 | $524.81 |