- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.61 / $80.78 / $114.12
| Professional | | $70.61 | $80.78 | $114.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.01 / $119.08 / $324.18
| Professional | | $101.01 | $119.08 | $324.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.89 / $91.46 / $185.91
| Professional | | $72.89 | $91.46 | $185.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.90 / $91.46 / $175.96
| Professional | | $82.90 | $91.46 | $175.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.90 / $102.08 / $220.56
| Professional | | $70.90 | $102.08 | $220.56 |