- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $83.18 / $177.83
| Professional | | $45.71 | $83.18 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $107.15 / $107.15 / $107.15
| Professional | 50 | $107.15 | $107.15 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $85.11 / $269.15
| Professional | | $72.44 | $85.11 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $74.13 / $104.71
| Professional | | $42.66 | $74.13 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $83.18 / $95.50
| Professional | | $57.54 | $83.18 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $74.13 / $131.83
| Professional | | $54.95 | $74.13 | $131.83 |