- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $173.78 / $234.42
| Facility | | $47.86 | $173.78 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $19.50 / $38.90
| Professional | | $9.77 | $19.50 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $28.18 / $33.88
| Professional | | $28.18 | $28.18 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $28.84
| Professional | | $28.84 | $28.84 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $295.12 / $3,090.30
| Facility | | $51.29 | $295.12 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $26.30 / $63.10
| Professional | | $16.22 | $26.30 | $63.10 |