- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.20 / $265.60 / $372.50
| Professional | | $196.20 | $265.60 | $372.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.34 / $252.53 / $252.53
| Professional | | $243.34 | $252.53 | $252.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.09 / $309.92 / $522.33
| Professional | | $233.09 | $309.92 | $522.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.06 / $384.66 / $505.31
| Professional | | $264.06 | $384.66 | $505.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.75 / $291.17 / $568.97
| Professional | | $232.75 | $291.17 | $568.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.69 / $142.69 / $590.90
| Professional | | $142.69 | $142.69 | $590.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.05 / $309.92 / $549.00
| Professional | | $241.05 | $309.92 | $549.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.87 / $260.05 / $283.02
| Professional | | $255.87 | $260.05 | $283.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.83 / $279.17 / $450.68
| Professional | | $222.83 | $279.17 | $450.68 |