- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.71 / $233.12 / $251.53
| Professional | | $126.71 | $233.12 | $251.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.06 / $191.86 / $273.42
| Professional | | $140.06 | $191.86 | $273.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.04 / $280.20 / $544.66
| Professional | | $174.04 | $280.20 | $544.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.42 / $206.50 / $387.44
| Professional | | $115.42 | $206.50 | $387.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.83 / $234.66 / $307.92
| Professional | | $159.83 | $234.66 | $307.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.38 / $242.74 / $379.10
| Professional | | $153.38 | $242.74 | $379.10 |