- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.68 / $85.92 / $151.71
| Professional | | $48.68 | $85.92 | $151.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.44 / $68.44 / $116.97
| Professional | | $68.44 | $68.44 | $116.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.33 / $96.52 / $163.78
| Professional | | $55.33 | $96.52 | $163.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.78 / $125.31 / $1,193.03
| Professional | | $88.78 | $125.31 | $1,193.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.12 / $108.24 / $182.50
| Professional | | $86.12 | $108.24 | $182.50 |