- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.21 / $20.00 / $501.96
| Professional | | $16.21 | $20.00 | $501.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.28 / $19.73 / $410.10
| Professional | | $10.28 | $19.73 | $410.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.16 / $71.53 / $1,191.85
| Professional | | $15.16 | $71.53 | $1,191.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.37 / $440.68 / $1,204.34
| Professional | | $22.37 | $440.68 | $1,204.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.34 / $343.09 / $530.07
| Professional | | $106.34 | $343.09 | $530.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.76 / $162.29 / $369.43
| Professional | | $15.76 | $162.29 | $369.43 |