- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.30 / $97.90 / $324.86
| Professional | | $66.30 | $97.90 | $324.86 |
- 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
- $108.84 / $108.84 / $186.66
| Professional | | $108.84 | $108.84 | $186.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.84 / $219.00 / $422.43
| Facility | | $108.84 | $219.00 | $422.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.23 / $118.73 / $188.83
| Professional | | $74.23 | $118.73 | $188.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.59 / $156.19 / $219.00
| Facility | | $78.59 | $156.19 | $219.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.58 / $149.56 / $264.11
| Professional | | $92.58 | $149.56 | $264.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.32 / $176.00 / $197.77
| Professional | | $148.32 | $176.00 | $197.77 |