- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.52 / $79.40 / $366.93
| Professional | | $59.52 | $79.40 | $366.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.68 / $77,999.99 / $94,999.99
| Facility | | $236.68 | $77,999.99 | $94,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.84 / $57.84 / $113.05
| Professional | | $57.84 | $57.84 | $113.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.49 / $113.05 / $191.92
| Facility | | $99.49 | $113.05 | $191.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.83 / $113.05 / $118.73
| Professional | | $72.83 | $113.05 | $118.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.77 / $117.00 / $127.77
| Facility | | $68.77 | $117.00 | $127.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.29 / $100.94 / $145.60
| Professional | | $67.29 | $100.94 | $145.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.00 / $117.00 / $195.17
| Professional | | $94.00 | $117.00 | $195.17 |