- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.32 / $124.13 / $256.33
| Professional | | $100.32 | $124.13 | $256.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.84 / $246.21 / $3,176.85
| Professional | | $147.84 | $246.21 | $3,176.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.19 / $196.34 / $318.24
| Professional | | $106.19 | $196.34 | $318.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.12 / $173.65 / $271.31
| Professional | | $100.12 | $173.65 | $271.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.61 / $164.11 / $278.44
| Professional | | $27.61 | $164.11 | $278.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.25 / $235.84 / $288.70
| Professional | | $148.25 | $235.84 | $288.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.84 / $202.11 / $265.00
| Professional | | $147.84 | $202.11 | $265.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.76 / $164.08 / $294.31
| Professional | | $103.76 | $164.08 | $294.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.61 / $113.66 / $113.66
| Professional | | $80.61 | $113.66 | $113.66 |