- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.44 / $227.06 / $429.80
| Professional | | $132.44 | $227.06 | $429.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.05 / $265.81 / $582.84
| Professional | | $214.05 | $265.81 | $582.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.89 / $200.89 / $335.53
| Professional | | $200.89 | $200.89 | $335.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.32 / $329.18 / $782.63
| Professional | | $153.32 | $329.18 | $782.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.55 / $264.81 / $458.12
| Professional | | $87.55 | $264.81 | $458.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.85 / $247.22 / $424.89
| Professional | | $173.85 | $247.22 | $424.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.40 / $333.11 / $786.09
| Professional | | $170.40 | $333.11 | $786.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.76 / $281.85 / $706.50
| Professional | | $136.76 | $281.85 | $706.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.85 / $265.29 / $466.67
| Professional | | $173.85 | $265.29 | $466.67 |