- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.98 / $185.70 / $264.62
| Professional | | $113.98 | $185.70 | $264.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.54 / $135.87 / $253.98
| Professional | | $34.54 | $135.87 | $253.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.50 / $197.68 / $571.17
| Professional | | $117.50 | $197.68 | $571.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.19 / $244.28 / $304.70
| Professional | | $157.19 | $244.28 | $304.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.26 / $219.44 / $305.01
| Professional | | $176.26 | $219.44 | $305.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.15 / $272.86 / $365.18
| Professional | | $223.15 | $272.86 | $365.18 |