- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.30 / $191.47 / $213.76
| Professional | | $176.30 | $191.47 | $213.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.16 / $217.53 / $351.41
| Professional | | $179.16 | $217.53 | $351.41 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $268.74 / $325.77 / $527.11
| Professional | 50 | $268.74 | $325.77 | $527.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.37 / $292.42 / $480.43
| Professional | | $184.37 | $292.42 | $480.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.93 / $312.51 / $1,418.24
| Professional | | $196.93 | $312.51 | $1,418.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.36 / $267.19 / $414.25
| Professional | | $195.36 | $267.19 | $414.25 |