- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.51 / $241.25 / $250.53
| Professional | | $168.51 | $241.25 | $250.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.82 / $279.37 / $544.78
| Professional | | $52.82 | $279.37 | $544.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.59 / $215.43 / $400.71
| Professional | | $137.59 | $215.43 | $400.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.58 / $205.28 / $330.29
| Professional | | $202.58 | $205.28 | $330.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.22 / $170.59 / $244.30
| Professional | | $137.22 | $170.59 | $244.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.86 / $233.54 / $345.61
| Professional | | $202.86 | $233.54 | $345.61 |