- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.82 / $141.30 / $246.20
| Professional | | $118.82 | $141.30 | $246.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.79 / $157.46 / $367.45
| Professional | | $126.79 | $157.46 | $367.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.05 / $136.35 / $189.40
| Professional | | $53.05 | $136.35 | $189.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.84 / $278.70 / $596.85
| Professional | | $124.84 | $278.70 | $596.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.35 / $192.56 / $289.41
| Professional | | $149.35 | $192.56 | $289.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.78 / $158.82 / $228.74
| Professional | | $78.78 | $158.82 | $228.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.68 / $244.11 / $513.70
| Professional | | $143.68 | $244.11 | $513.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.46 / $177.27 / $438.61
| Professional | | $124.46 | $177.27 | $438.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.53 / $171.88 / $317.42
| Professional | | $118.53 | $171.88 | $317.42 |