- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.06 / $244.24 / $297.36
| Facility | | $158.06 | $244.24 | $297.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.11 / $54.02 / $74.14
| Professional | | $50.11 | $54.02 | $74.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.04 / $124.89 / $140.16
| Professional | | $103.04 | $124.89 | $140.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.45 / $72.16 / $90.74
| Professional | | $71.45 | $72.16 | $90.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.50 / $121.45 / $270.54
| Facility | | $47.50 | $121.45 | $270.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.73 / $59.36 / $106.28
| Professional | | $30.73 | $59.36 | $106.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.03 / $68.18 / $106.28
| Professional | | $26.03 | $68.18 | $106.28 |