- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.98 / $107.29 / $149.94
| Professional | | $100.98 | $107.29 | $149.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.25 / $165.51 / $252.05
| Professional | | $102.25 | $165.51 | $252.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.76 / $88.67 / $203.70
| Professional | | $82.76 | $88.67 | $203.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.57 / $111.90 / $151.06
| Professional | | $77.57 | $111.90 | $151.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.73 / $146.34 / $245.49
| Professional | | $101.73 | $146.34 | $245.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.49 / $100.49 / $100.49
| Professional | | $100.49 | $100.49 | $100.49 |