- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.93 / $322.77 / $599.24
| Professional | | $198.93 | $322.77 | $599.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.77 / $335.02 / $766.73
| Professional | | $263.77 | $335.02 | $766.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.93 / $280.93 / $495.79
| Professional | | $280.93 | $280.93 | $495.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.14 / $421.40 / $1,079.34
| Professional | | $214.14 | $421.40 | $1,079.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.15 / $513.69 / $756.33
| Professional | | $364.15 | $513.69 | $756.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.45 / $344.09 / $714.10
| Professional | | $277.45 | $344.09 | $714.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.20 / $452.76 / $1,062.93
| Professional | | $219.20 | $452.76 | $1,062.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.91 / $420.93 / $999.89
| Professional | | $293.91 | $420.93 | $999.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.23 / $421.01 / $714.10
| Professional | | $286.23 | $421.01 | $714.10 |