- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.25 / $229.91 / $376.39
| Professional | | $214.25 | $229.91 | $376.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64,999.99 / $81,499.99 / $94,999.99
| Facility | | $64,999.99 | $81,499.99 | $94,999.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.46 / $335.46 / $335.46
| Facility | | $335.46 | $335.46 | $335.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.46 / $335.46 / $630.16
| Professional | | $335.46 | $335.46 | $630.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.89 / $194.81 / $335.46
| Facility | | $126.89 | $194.81 | $335.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.20 / $335.46 / $442.40
| Professional | | $197.20 | $335.46 | $442.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.20 / $287.83 / $592.80
| Professional | | $250.20 | $287.83 | $592.80 |