- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.45 / $129.68 / $206.40
| Facility | | $0.45 | $129.68 | $206.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.79 / $192.36 / $257.80
| Professional | | $118.79 | $192.36 | $257.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.61 / $238.44 / $326.64
| Professional | | $149.61 | $238.44 | $326.64 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $224.41 / $357.66 / $489.96
| Professional | 50 | $224.41 | $357.66 | $489.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.72 / $277.39 / $482.61
| Professional | | $171.72 | $277.39 | $482.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.24 / $265.04 / $412.40
| Professional | | $170.24 | $265.04 | $412.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.45 / $0.45 / $0.45
| Facility | | $0.45 | $0.45 | $0.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.68 / $206.40 / $336.33
| Professional | | $129.68 | $206.40 | $336.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.61 / $313.88 / $462.59
| Professional | | $205.61 | $313.88 | $462.59 |