- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.88 / $183.18 / $251.98
| Professional | | $153.88 | $183.18 | $251.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.90 / $181.50 / $347.32
| Professional | | $174.90 | $181.50 | $347.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.91 / $230.66 / $361.80
| Professional | | $145.91 | $230.66 | $361.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.90 / $253.90 / $283.35
| Professional | | $253.90 | $253.90 | $283.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.26 / $189.40 / $748.13
| Professional | | $159.26 | $189.40 | $748.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.05 / $198.82 / $273.52
| Professional | | $52.05 | $198.82 | $273.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.15 / $230.66 / $383.44
| Professional | | $147.15 | $230.66 | $383.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.05 / $175.02 / $190.27
| Professional | | $172.05 | $175.02 | $190.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.02 / $218.74 / $348.82
| Professional | | $169.02 | $218.74 | $348.82 |