- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.80 / $75.30 / $101.12
| Professional | | $46.80 | $75.30 | $101.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.84 / $66.81 / $108.07
| Professional | | $42.84 | $66.81 | $108.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.67 / $65.61 / $118.79
| Professional | | $51.67 | $65.61 | $118.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.31 / $88.60 / $153.79
| Professional | | $51.31 | $88.60 | $153.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.69 / $102.53 / $161.38
| Professional | | $73.69 | $102.53 | $161.38 |