- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $269.15 / $380.19
| Professional | | $223.87 | $269.15 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $61.66 / $588.84
| Professional | | $45.71 | $61.66 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $104.71 / $758.58
| Professional | | $60.26 | $104.71 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $32.36 / $676.08
| Professional | | $31.62 | $32.36 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.11 / $33.11 / $1,202.26
| Facility | | $33.11 | $33.11 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $30.90 / $61.66
| Professional | | $17.38 | $30.90 | $61.66 |