- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.37 / $175.22 / $278.88
| Professional | | $89.37 | $175.22 | $278.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.99 / $317.99 / $317.99
| Professional | | $317.99 | $317.99 | $317.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.06 / $218.40 / $399.09
| Professional | | $119.06 | $218.40 | $399.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.10 / $83.10 / $83.10
| Professional | | $83.10 | $83.10 | $83.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.62 / $198.93 / $378.34
| Professional | | $114.62 | $198.93 | $378.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.06 / $194.42 / $314.99
| Professional | | $102.06 | $194.42 | $314.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.22 / $234.19 / $310.80
| Professional | | $123.22 | $234.19 | $310.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.03 / $215.50 / $392.67
| Professional | | $147.03 | $215.50 | $392.67 |