- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.08 / $185.82 / $300.47
| Professional | | $42.08 | $185.82 | $300.47 |
- 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
- $69.41 / $69.41 / $69.41
| Facility | | $69.41 | $69.41 | $69.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.10 / $132.19 / $340.91
| Professional | | $44.10 | $132.19 | $340.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.72 / $185.82 / $312.07
| Facility | | $44.72 | $185.82 | $312.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.95 / $215.13 / $482.13
| Professional | | $60.95 | $215.13 | $482.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.55 / $303.48 / $365.29
| Professional | | $221.55 | $303.48 | $365.29 |