- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.01 / $34.22 / $247.00
| Professional | | $22.01 | $34.22 | $247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.63 / $63.96 / $101.07
| Professional | | $43.63 | $63.96 | $101.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.82 / $34.65 / $40.01
| Professional | | $31.82 | $34.65 | $40.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.50 / $31.50 / $44.10
| Professional | | $31.50 | $31.50 | $44.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.10 / $54.13 / $106.62
| Professional | | $30.10 | $54.13 | $106.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.08 / $50.47 / $101.81
| Professional | | $32.08 | $50.47 | $101.81 |