- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.87 / $84.96 / $346.81
| Professional | | $59.87 | $84.96 | $346.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.81 / $122.18 / $237.25
| Professional | | $69.81 | $122.18 | $237.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.80 / $91.46 / $209.84
| Professional | | $73.80 | $91.46 | $209.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.16 / $99.69 / $190.74
| Professional | | $80.16 | $99.69 | $190.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.71 / $78.63 / $154.22
| Professional | | $57.71 | $78.63 | $154.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.75 / $99.69 / $202.96
| Professional | | $60.75 | $99.69 | $202.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.18 / $215.18 / $215.18
| Professional | | $215.18 | $215.18 | $215.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.62 / $94.82 / $146.04
| Professional | | $64.62 | $94.82 | $146.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $85.90 / $200.06
| Professional | | $53.70 | $85.90 | $200.06 |