- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.50 / $271.39 / $409.55
| Facility | | $70.50 | $271.39 | $409.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.85 / $62.93 / $168.21
| Professional | | $43.85 | $62.93 | $168.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.95 / $135.68 / $183.38
| Professional | | $99.95 | $135.68 | $183.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $149.93 / $194.03 / $275.07
| Professional | 50 | $149.93 | $194.03 | $275.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.70 / $145.08 / $237.93
| Professional | | $71.70 | $145.08 | $237.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.20 / $84.19 / $142.62
| Facility | | $49.20 | $84.19 | $142.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.54 / $136.10 / $370.64
| Professional | | $72.54 | $136.10 | $370.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.54 / $129.33 / $173.57
| Professional | | $72.54 | $129.33 | $173.57 |