- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.49 / $127.46 / $153.72
| Professional | | $115.49 | $127.46 | $153.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.06 / $84.78 / $127.27
| Professional | | $72.06 | $84.78 | $127.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.80 / $128.93 / $166.20
| Professional | | $110.80 | $128.93 | $166.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.16 / $145.90 / $241.62
| Professional | | $107.16 | $145.90 | $241.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $130.94
| Professional | | $32.34 | $32.34 | $130.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.13 / $133.71 / $236.12
| Professional | | $100.13 | $133.71 | $236.12 |