- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.47 / $114.67 / $275.83
| Facility | | $73.47 | $114.67 | $275.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.21 / $61.87 / $106.22
| Professional | | $49.21 | $61.87 | $106.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.96 / $101.10 / $217.20
| Facility | | $58.96 | $101.10 | $217.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.72 / $57.67 / $98.35
| Professional | | $48.72 | $57.67 | $98.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.36 / $62.56 / $83.49
| Facility | | $47.36 | $62.56 | $83.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.59 / $236.59 / $236.59
| Professional | | $236.59 | $236.59 | $236.59 |