- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.81 / $169.67 / $268.10
| Professional | | $95.81 | $169.67 | $268.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.28 / $143.36 / $212.46
| Professional | | $121.28 | $143.36 | $212.46 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $181.93 / $214.03 / $316.64
| Professional | 50 | $181.93 | $214.03 | $316.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.64 / $531.64 / $531.64
| Facility | | $531.64 | $531.64 | $531.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.35 / $238.56 / $356.92
| Professional | | $170.35 | $238.56 | $356.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.85 / $215.99 / $336.08
| Professional | | $136.85 | $215.99 | $336.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.81 / $156.13 / $268.06
| Professional | | $95.81 | $156.13 | $268.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.94 / $227.14 / $293.72
| Professional | | $149.94 | $227.14 | $293.72 |