- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.62 / $170.70 / $224.35
| Professional | | $135.62 | $170.70 | $224.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.50 / $372.84 / $1,460.40
| Professional | | $227.50 | $372.84 | $1,460.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.15 / $154.15 / $154.15
| Professional | | $154.15 | $154.15 | $154.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.96 / $199.60 / $357.18
| Professional | | $148.96 | $199.60 | $357.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.14 / $248.22 / $432.33
| Professional | | $46.14 | $248.22 | $432.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.39 / $368.21 / $471.69
| Professional | | $241.39 | $368.21 | $471.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.01 / $295.26 / $429.94
| Professional | | $237.01 | $295.26 | $429.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.84 / $306.35 / $492.11
| Professional | | $224.84 | $306.35 | $492.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.00 / $143.00 / $168.99
| Professional | | $143.00 | $143.00 | $168.99 |