- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.50 / $105.48 / $251.35
| Professional | | $84.50 | $105.48 | $251.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $576.03 / $851.75 / $1,194.23
| Professional | | $576.03 | $851.75 | $1,194.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.64 / $272.20 / $571.33
| Professional | | $191.64 | $272.20 | $571.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.19 / $300.33 / $562.33
| Professional | | $182.19 | $300.33 | $562.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.58 / $255.08 / $822.37
| Professional | | $124.58 | $255.08 | $822.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.89 / $205.58 / $261.64
| Professional | | $186.89 | $205.58 | $261.64 |