- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.52 / $88.37 / $122.58
| Professional | | $66.52 | $88.37 | $122.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.24 / $220.57 / $308.92
| Professional | | $117.24 | $220.57 | $308.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.35 / $131.22 / $264.47
| Professional | | $104.35 | $131.22 | $264.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.32 / $125.46 / $254.49
| Professional | | $103.32 | $125.46 | $254.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.28 / $324.08 / $660.93
| Professional | | $122.28 | $324.08 | $660.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.83 / $243.55 / $400.44
| Professional | | $115.83 | $243.55 | $400.44 |