- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.66 / $147.99 / $235.94
| Professional | | $104.66 | $147.99 | $235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.07 / $195.56 / $533.64
| Professional | | $97.07 | $195.56 | $533.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.49 / $310.89 / $427.44
| Professional | | $137.49 | $310.89 | $427.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.83 / $313.11 / $880.77
| Professional | | $128.83 | $313.11 | $880.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.38 / $91.28 / $188.51
| Professional | | $47.38 | $91.28 | $188.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.40 / $277.67 / $396.00
| Professional | | $194.40 | $277.67 | $396.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.25 / $650.65 / $880.77
| Professional | | $180.25 | $650.65 | $880.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.04 / $533.36 / $627.95
| Professional | | $246.04 | $533.36 | $627.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.38 / $271.56 / $487.99
| Professional | | $133.38 | $271.56 | $487.99 |