- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $295.12 / $501.19
| Professional | | $186.21 | $295.12 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $223.87 / $416.87
| Professional | | $158.49 | $223.87 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $338.84 / $1,047.13
| Professional | | $181.97 | $338.84 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $380.19 / $562.34
| Professional | | $199.53 | $380.19 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $295.12 / $912.01
| Professional | | $173.78 | $295.12 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $354.81 / $512.86
| Professional | | $239.88 | $354.81 | $512.86 |