- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $374.99 / $374.99 / $8,500.00
| Facility | | $374.99 | $374.99 | $8,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.88 / $374.99 / $374.99
| Professional | | $333.88 | $374.99 | $374.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $765.60 / $834.90 / $987.46
| Professional | | $765.60 | $834.90 | $987.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.13 / $878.14 / $1,133.99
| Professional | | $479.13 | $878.14 | $1,133.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $374.99 / $535.20 / $1,124.97
| Facility | | $374.99 | $535.20 | $1,124.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.86 / $694.52 / $962.03
| Professional | | $406.86 | $694.52 | $962.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.86 / $739.74 / $962.03
| Professional | | $406.86 | $739.74 | $962.03 |