- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.77 / $187.71 / $327.68
| Professional | | $135.77 | $187.71 | $327.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.58 / $160.94 / $288.42
| Professional | | $102.58 | $160.94 | $288.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.64 / $200.15 / $200.15
| Professional | | $175.64 | $200.15 | $200.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.94 / $210.98 / $352.64
| Professional | | $148.94 | $210.98 | $352.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.75 / $218.22 / $357.73
| Professional | | $158.75 | $218.22 | $357.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.17 / $214.30 / $295.10
| Professional | | $155.17 | $214.30 | $295.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.68 / $214.70 / $359.16
| Professional | | $142.68 | $214.70 | $359.16 |