- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.74 / $268.99 / $361.01
| Professional | | $186.74 | $268.99 | $361.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.13 / $230.30 / $371.94
| Professional | | $160.13 | $230.30 | $371.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.37 / $252.72 / $401.36
| Professional | | $174.37 | $252.72 | $401.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.46 / $298.22 / $551.09
| Professional | | $200.46 | $298.22 | $551.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $291.39
| Professional | | $32.34 | $32.34 | $291.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.99 / $351.74 / $577.54
| Professional | | $248.99 | $351.74 | $577.54 |