- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.69 / $224.16 / $988.51
| Professional | | $148.69 | $224.16 | $988.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.49 / $224.97 / $725.04
| Professional | | $172.49 | $224.97 | $725.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.79 / $105.67 / $197.89
| Facility | | $72.79 | $105.67 | $197.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.65 / $93.34 / $197.89
| Professional | | $68.65 | $93.34 | $197.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.84 / $583.84 / $795.70
| Professional | | $583.84 | $583.84 | $795.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $353.96
| Professional | | $32.34 | $32.34 | $353.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.35 / $238.89 / $518.10
| Professional | | $152.35 | $238.89 | $518.10 |