- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.65 / $622.71 / $962.21
| Facility | | $331.65 | $622.71 | $962.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.01 / $262.17 / $322.44
| Professional | | $226.01 | $262.17 | $322.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.69 / $376.69 / $376.69
| Professional | | $376.69 | $376.69 | $376.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.39 / $493.62 / $683.10
| Facility | | $266.39 | $493.62 | $683.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.08 / $301.35 / $405.40
| Facility | | $241.08 | $301.35 | $405.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.57 / $180.81 / $1,500.72
| Professional | | $126.57 | $180.81 | $1,500.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.57 / $180.81 / $452.03
| Professional | | $126.57 | $180.81 | $452.03 |