- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.79 / $113.35 / $354.35
| Professional | | $47.79 | $113.35 | $354.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.78 / $88.73 / $144.30
| Professional | | $74.78 | $88.73 | $144.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.20 / $130.80 / $308.67
| Professional | | $67.20 | $130.80 | $308.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.45 / $104.54 / $146.31
| Professional | | $52.45 | $104.54 | $146.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.11 / $119.14 / $202.95
| Professional | | $83.11 | $119.14 | $202.95 |