- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.49 / $399.49 / $512.71
| Facility | | $352.49 | $399.49 | $512.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.45 / $226.45 / $226.45
| Professional | | $226.45 | $226.45 | $226.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.71 / $512.71 / $512.71
| Professional | | $512.71 | $512.71 | $512.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.65 / $482.80 / $534.08
| Professional | | $402.65 | $482.80 | $534.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.99 / $512.71 / $598.16
| Professional | | $469.99 | $512.71 | $598.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.26 / $512.71 / $640.89
| Professional | | $427.26 | $512.71 | $640.89 |