- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.44 / $204.64 / $359.67
| Professional | | $147.44 | $204.64 | $359.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.31 / $263.14 / $444.12
| Professional | | $190.31 | $263.14 | $444.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.74 / $257.51 / $414.52
| Professional | | $166.74 | $257.51 | $414.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.13 / $327.74 / $541.48
| Professional | | $207.13 | $327.74 | $541.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.32 / $200.64 / $304.33
| Professional | | $189.32 | $200.64 | $304.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $344.13
| Professional | | $32.34 | $32.34 | $344.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.27 / $269.39 / $479.57
| Professional | | $204.27 | $269.39 | $479.57 |