- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.86 / $762.60 / $812.07
| Facility | | $0.86 | $762.60 | $812.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.37 / $454.31 / $812.07
| Professional | | $348.37 | $454.31 | $812.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.32 / $277.20 / $361.71
| Professional | | $221.32 | $277.20 | $361.71 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $331.98 / $415.82 / $542.57
| Professional | 50 | $331.98 | $415.82 | $542.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.64 / $531.64 / $531.64
| Facility | | $531.64 | $531.64 | $531.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.66 / $438.74 / $647.73
| Professional | | $332.66 | $438.74 | $647.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.63 / $306.18 / $469.69
| Professional | | $264.63 | $306.18 | $469.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.86 / $0.86 / $0.86
| Facility | | $0.86 | $0.86 | $0.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.95 / $411.16 / $812.07
| Professional | | $257.95 | $411.16 | $812.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.12 / $705.71 / $882.73
| Professional | | $431.12 | $705.71 | $882.73 |