- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.44 / $211.74 / $443.40
| Professional | | $73.44 | $211.74 | $443.40 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $127.77 / $127.77 / $481.63
| Professional | | $127.77 | $127.77 | $481.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.77 / $266.60 / $514.25
| Facility | | $127.77 | $266.60 | $514.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.62 / $237.15 / $513.44
| Professional | | $80.62 | $237.15 | $513.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.53 / $269.68 / $450.46
| Facility | | $88.53 | $269.68 | $450.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.83 / $315.41 / $706.88
| Professional | | $111.83 | $315.41 | $706.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.99 / $453.43 / $535.04
| Professional | | $356.99 | $453.43 | $535.04 |