- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.43 / $115.40 / $129.69
| Professional | | $100.43 | $115.40 | $129.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.97 / $165.75 / $197.33
| Professional | | $149.97 | $165.75 | $197.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.95 / $211.68 / $503.96
| Professional | | $81.95 | $211.68 | $503.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.89 / $115.27 / $156.04
| Professional | | $97.89 | $115.27 | $156.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.15 / $101.62 / $147.35
| Professional | | $82.15 | $101.62 | $147.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.01 / $120.91 / $173.61
| Professional | | $101.01 | $120.91 | $173.61 |