- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.47 / $97.47 / $110.78
| Professional | | $73.47 | $97.47 | $110.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.43 / $105.16 / $149.08
| Professional | | $93.43 | $105.16 | $149.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $81.28 / $81.28
| Facility | | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.05 / $107.41 / $170.21
| Professional | | $77.05 | $107.41 | $170.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.65 / $100.11 / $185.23
| Professional | | $76.65 | $100.11 | $185.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.47 / $97.47 / $110.85
| Professional | | $73.47 | $97.47 | $110.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.65 / $108.96 / $148.47
| Professional | | $76.65 | $108.96 | $148.47 |