- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.88 / $58.47 / $67.84
| Professional | | $44.88 | $58.47 | $67.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.81 / $128.13 / $203.10
| Professional | | $48.81 | $128.13 | $203.10 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $73.20 / $192.21 / $304.64
| Professional | 50 | $73.20 | $192.21 | $304.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.35 / $71.69 / $103.23
| Professional | | $57.35 | $71.69 | $103.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.18 / $67.34 / $244.60
| Professional | | $50.18 | $67.34 | $244.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.69 / $70.31 / $123.42
| Professional | | $55.69 | $70.31 | $123.42 |