- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.27 / $173.70 / $188.13
| Professional | | $159.27 | $173.70 | $188.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.91 / $268.57 / $294.83
| Professional | | $160.91 | $268.57 | $294.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.04 / $174.58 / $320.13
| Professional | | $129.04 | $174.58 | $320.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.93 / $251.91 / $259.30
| Professional | | $195.93 | $251.91 | $259.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.25 / $175.01 / $234.50
| Professional | | $156.25 | $175.01 | $234.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.06 / $189.77 / $381.61
| Professional | | $151.06 | $189.77 | $381.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.18 / $163.96 / $178.09
| Professional | | $161.18 | $163.96 | $178.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.74 / $166.99 / $325.01
| Professional | | $134.74 | $166.99 | $325.01 |