- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.59 / $223.31 / $338.09
| Professional | | $153.59 | $223.31 | $338.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.99 / $170.52 / $266.60
| Professional | | $135.99 | $170.52 | $266.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.99 / $230.67 / $362.59
| Professional | | $176.99 | $230.67 | $362.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.74 / $299.07 / $496.42
| Professional | | $200.74 | $299.07 | $496.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $73.09 / $266.51
| Professional | | $32.34 | $73.09 | $266.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.23 / $321.98 / $503.07
| Professional | | $232.23 | $321.98 | $503.07 |