- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.06 / $279.49 / $503.45
| Professional | | $165.06 | $279.49 | $503.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.35 / $478.33 / $1,638.45
| Professional | | $269.35 | $478.33 | $1,638.45 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $286.70 / $541.44 / $622.50
| Professional | 50 | $286.70 | $541.44 | $622.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.49 / $407.04 / $601.12
| Professional | | $236.49 | $407.04 | $601.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.16 / $405.60 / $1,049.08
| Professional | | $263.16 | $405.60 | $1,049.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.97 / $278.79 / $453.80
| Professional | | $42.97 | $278.79 | $453.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.06 / $439.80 / $535.20
| Professional | | $282.06 | $439.80 | $535.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $268.88 / $375.37 / $505.62
| Professional | | $268.88 | $375.37 | $505.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.16 / $413.49 / $558.05
| Professional | | $237.16 | $413.49 | $558.05 |