- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.38 / $178.97 / $729.17
| Professional | | $128.38 | $178.97 | $729.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64,999.99 / $77,999.99 / $94,999.99
| Facility | | $64,999.99 | $77,999.99 | $94,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.95 / $212.95 / $291.29
| Professional | | $212.95 | $212.95 | $291.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.95 / $212.95 / $212.95
| Facility | | $212.95 | $212.95 | $212.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.01 / $236.87 / $320.10
| Professional | | $181.01 | $236.87 | $320.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.99 / $179.58 / $311.35
| Facility | | $119.99 | $179.58 | $311.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.05 / $247.60 / $349.61
| Professional | | $172.05 | $247.60 | $349.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.82 / $316.10 / $345.42
| Professional | | $277.82 | $316.10 | $345.42 |