- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $43.65 / $120.23
| Professional | | $33.88 | $43.65 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $95.50 / $112.20
| Professional | | $74.13 | $95.50 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $77.62 / $109.65
| Professional | | $43.65 | $77.62 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $47.86 / $77.62
| Facility | | $36.31 | $47.86 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $56.23 / $288.40
| Professional | | $45.71 | $56.23 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $56.23 / $107.15
| Professional | | $39.81 | $56.23 | $107.15 |