- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.06 / $67.17 / $95.92
| Professional | | $48.06 | $67.17 | $95.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.69 / $116.75 / $271.45
| Professional | | $81.69 | $116.75 | $271.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.18 / $153.97 / $225.84
| Professional | | $123.18 | $153.97 | $225.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.09 / $101.18 / $242.70
| Professional | | $71.09 | $101.18 | $242.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.79 / $98.82 / $168.00
| Professional | | $59.79 | $98.82 | $168.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.28 / $205.48 / $302.91
| Professional | | $108.28 | $205.48 | $302.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $55.00
| Professional | | $55.00 | $55.00 | $55.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.69 / $101.50 / $637.99
| Professional | | $81.69 | $101.50 | $637.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.20 / $97.41 / $172.86
| Professional | | $79.20 | $97.41 | $172.86 |