- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.55 / $268.14 / $374.40
| Professional | | $174.55 | $268.14 | $374.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.81 / $252.58 / $397.32
| Professional | | $177.81 | $252.58 | $397.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.09 / $264.89 / $378.42
| Professional | | $172.09 | $264.89 | $378.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.56 / $324.64 / $749.99
| Professional | | $204.56 | $324.64 | $749.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $379.11
| Professional | | $32.34 | $32.34 | $379.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.30 / $394.39 / $604.32
| Professional | | $317.30 | $394.39 | $604.32 |