- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.26 / $77.36 / $111.42
| Professional | | $31.26 | $77.36 | $111.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.49 / $59.70 / $126.10
| Professional | | $32.49 | $59.70 | $126.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.58 / $74.56 / $200.00
| Professional | | $31.58 | $74.56 | $200.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.44 / $91.21 / $252.03
| Professional | | $34.44 | $91.21 | $252.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.18 / $102.74 / $241.75
| Professional | | $48.18 | $102.74 | $241.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.95 / $34.93 / $93.94
| Professional | | $24.95 | $34.93 | $93.94 |