- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $37.15 / $46.77
| Professional | | $28.18 | $37.15 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $64.57 / $77.62
| Professional | | $61.66 | $64.57 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $38.02 / $64.57
| Facility | | $37.15 | $38.02 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $18.20 / $281.84
| Professional | | $14.45 | $18.20 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $16.98 / $48.98
| Professional | | $14.45 | $16.98 | $48.98 |