- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $144.54 / $234.42
| Professional | | $117.49 | $144.54 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $141.25 / $416.87
| Professional | | $41.69 | $141.25 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $181.97 / $371.54
| Professional | | $128.82 | $181.97 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $169.82 / $295.12
| Professional | | $144.54 | $169.82 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $162.18 / $309.03
| Professional | | $123.03 | $162.18 | $309.03 |