- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.78 / $33.25 / $80.20
| Professional | | $29.78 | $33.25 | $80.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.36 / $136.36 / $136.36
| Facility | | $136.36 | $136.36 | $136.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.64 / $72.54 / $81.54
| Professional | | $48.64 | $72.54 | $81.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.71 / $100.75 / $118.43
| Professional | | $42.71 | $100.75 | $118.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.78 / $33.25 / $210.41
| Facility | | $29.78 | $33.25 | $210.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.38 / $54.69 / $328.55
| Professional | | $50.38 | $54.69 | $328.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.95 / $68.73 / $125.21
| Facility | | $53.95 | $68.73 | $125.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.95 / $92.53 / $116.79
| Professional | | $53.95 | $92.53 | $116.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $52.37 / $104.74
| Professional | | $47.86 | $52.37 | $104.74 |