- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.53 / $58.53 / $123.22
| Professional | | $58.53 | $58.53 | $123.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.27 / $56.41 / $73.34
| Professional | | $51.27 | $56.41 | $73.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.45 / $32.57 / $106.66
| Professional | | $24.45 | $32.57 | $106.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.91 / $56.57 / $64.79
| Professional | | $50.91 | $56.57 | $64.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.95 / $46.40 / $82.79
| Professional | | $37.95 | $46.40 | $82.79 |