- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.55 / $235.43 / $312.29
| Professional | | $151.55 | $235.43 | $312.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.64 / $261.14 / $458.64
| Professional | | $251.64 | $261.14 | $458.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.81 / $256.75 / $459.11
| Professional | | $162.81 | $256.75 | $459.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.12 / $403.75 / $521.84
| Professional | | $302.12 | $403.75 | $521.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.61 / $256.12 / $870.26
| Professional | | $159.61 | $256.12 | $870.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.89 / $292.89 / $559.40
| Professional | | $292.89 | $292.89 | $559.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.42 / $260.36 / $469.44
| Professional | | $165.42 | $260.36 | $469.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.09 / $246.16 / $269.56
| Professional | | $158.09 | $246.16 | $269.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.45 / $306.77 / $504.75
| Professional | | $223.45 | $306.77 | $504.75 |