- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.90 / $87.53 / $147.88
| Professional | | $46.90 | $87.53 | $147.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.96 / $169.92 / $292.16
| Professional | | $102.96 | $169.92 | $292.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.59 / $215.55 / $767.12
| Professional | | $85.59 | $215.55 | $767.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.44 / $139.21 / $261.58
| Professional | | $110.44 | $139.21 | $261.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.16 / $129.80 / $198.60
| Professional | | $78.16 | $129.80 | $198.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.95 / $173.45 / $269.81
| Professional | | $91.95 | $173.45 | $269.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.80 / $120.90 / $241.10
| Professional | | $98.80 | $120.90 | $241.10 |