- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.46 / $37.20 / $71.44
| Professional | | $32.46 | $37.20 | $71.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.23 / $108.77 / $108.77
| Professional | | $106.23 | $108.77 | $108.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.15 / $39.15 / $39.15
| Professional | | $39.15 | $39.15 | $39.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.52 / $66.52 / $66.52
| Professional | | $66.52 | $66.52 | $66.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.79 / $40.70 / $48.32
| Professional | | $36.79 | $40.70 | $48.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.22 / $60.74 / $77.31
| Professional | | $55.22 | $60.74 | $77.31 |