- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.46 / $150.37 / $523.79
| Professional | | $107.46 | $150.37 | $523.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.01 / $99.98 / $140.08
| Professional | | $86.01 | $99.98 | $140.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.88 / $149.60 / $260.94
| Professional | | $97.88 | $149.60 | $260.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.07 / $190.80 / $1,128.08
| Professional | | $130.07 | $190.80 | $1,128.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.65 / $161.12 / $296.80
| Professional | | $125.65 | $161.12 | $296.80 |