- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $67.61 / $83.18
| Professional | | $48.98 | $67.61 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $104.71 / $104.71
| Professional | | $104.71 | $104.71 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $102.33 / $125.89
| Professional | | $67.61 | $102.33 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $104.71 / $281.84
| Professional | | $77.62 | $104.71 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $64.57 / $104.71
| Professional | | $34.67 | $64.57 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $89.13 / $281.84
| Professional | | $35.48 | $89.13 | $281.84 |