- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $87.10 / $151.36
| Professional | | $48.98 | $87.10 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $251.19 / $389.05
| Professional | | $138.04 | $251.19 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $117.49 / $245.47
| Professional | | $54.95 | $117.49 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $794.33 / $3,235.94
| Facility | | $602.56 | $794.33 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $123.03 / $275.42
| Professional | | $64.57 | $123.03 | $275.42 |