- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.94 / $130.25 / $162.91
| Professional | | $46.94 | $130.25 | $162.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.72 / $320.52 / $354.78
| Professional | | $259.72 | $320.52 | $354.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.69 / $202.77 / $362.71
| Professional | | $50.69 | $202.77 | $362.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.74 / $278.24 / $1,004.88
| Professional | | $160.74 | $278.24 | $1,004.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.03 / $264.33 / $383.73
| Professional | | $153.03 | $264.33 | $383.73 |