- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.37 / $135.79 / $216.42
| Professional | | $89.37 | $135.79 | $216.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.26 / $177.25 / $299.07
| Professional | | $87.26 | $177.25 | $299.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.26 / $188.04 / $340.00
| Professional | | $106.26 | $188.04 | $340.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.17 / $528.00 / $1,573.76
| Professional | | $236.17 | $528.00 | $1,573.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.63 / $224.15 / $343.13
| Professional | | $164.63 | $224.15 | $343.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.41 / $182.61 / $374.87
| Professional | | $131.41 | $182.61 | $374.87 |