- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $125.89 / $234.42
| Professional | | $112.20 | $125.89 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $114.82 / $204.17
| Professional | | $72.44 | $114.82 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $154.88 / $239.88
| Professional | | $107.15 | $154.88 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $162.18 / $245.47
| Professional | | $112.20 | $162.18 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $89.13
| Professional | | $32.36 | $33.11 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $144.54 / $269.15
| Professional | | $123.03 | $144.54 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $141.25 / $239.88
| Professional | | $102.33 | $141.25 | $239.88 |