- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.63 / $44.07 / $54.03
| Professional | | $43.63 | $44.07 | $54.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.65 / $25.65 / $25.65
| Professional | | $25.65 | $25.65 | $25.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.14 / $51.00 / $71.25
| Facility | | $32.14 | $51.00 | $71.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.65 / $46.79 / $10,000.00
| Professional | | $25.65 | $46.79 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.10 / $26.66 / $40.15
| Professional | | $24.10 | $26.66 | $40.15 |