- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.59 / $131.50 / $279.79
| Professional | | $79.59 | $131.50 | $279.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.87 / $90.44 / $131.65
| Professional | | $76.87 | $90.44 | $131.65 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $115.31 / $134.76 / $197.47
| Professional | 50 | $115.31 | $134.76 | $197.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.64 / $531.64 / $531.64
| Facility | | $531.64 | $531.64 | $531.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.24 / $226.85 / $377.17
| Professional | | $104.24 | $226.85 | $377.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.09 / $149.25 / $346.99
| Professional | | $84.09 | $149.25 | $346.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.59 / $126.63 / $301.77
| Professional | | $79.59 | $126.63 | $301.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.72 / $234.49 / $319.73
| Professional | | $161.72 | $234.49 | $319.73 |