- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.27 / $132.62 / $569.12
| Professional | | $42.27 | $132.62 | $569.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.32 / $397.32 / $420.70
| Professional | | $397.32 | $397.32 | $420.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $45.00 / $60.00
| Professional | | $30.00 | $45.00 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.30 / $88.59 / $631.49
| Professional | | $71.30 | $88.59 | $631.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.49 / $52.58 / $94.57
| Professional | | $45.49 | $52.58 | $94.57 |