- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.75 / $153.41 / $155.47
| Professional | | $134.75 | $153.41 | $155.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.58 / $207.31 / $236.33
| Professional | | $186.58 | $207.31 | $236.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.39 / $128.84 / $509.44
| Professional | | $109.39 | $128.84 | $509.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.31 / $248.77 / $310.97
| Professional | | $207.31 | $248.77 | $310.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.07 / $98.97 / $188.65
| Professional | | $87.07 | $98.97 | $188.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.66 / $164.81 / $164.81
| Professional | | $103.66 | $164.81 | $164.81 |