- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.48 / $282.70 / $536.29
| Professional | | $195.48 | $282.70 | $536.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.16 / $272.24 / $461.52
| Professional | | $179.16 | $272.24 | $461.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.22 / $299.51 / $299.51
| Professional | | $255.22 | $299.51 | $299.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.38 / $340.29 / $548.89
| Professional | | $230.38 | $340.29 | $548.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.81 / $347.86 / $554.69
| Professional | | $233.81 | $347.86 | $554.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.98 / $258.16 / $409.49
| Professional | | $32.98 | $258.16 | $409.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.89 / $404.13 / $709.22
| Professional | | $282.89 | $404.13 | $709.22 |