- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.94 / $95.33 / $119.49
| Professional | | $76.94 | $95.33 | $119.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.60 / $146.32 / $174.39
| Professional | | $127.60 | $146.32 | $174.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.36 / $141.36 / $160.44
| Professional | | $132.36 | $141.36 | $160.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $77.33 / $135.33
| Professional | | $32.34 | $77.33 | $135.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.03 / $122.39 / $150.11
| Professional | | $104.03 | $122.39 | $150.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.80 / $133.50 / $181.56
| Professional | | $100.80 | $133.50 | $181.56 |