- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.15 / $179.19 / $356.86
| Professional | | $128.15 | $179.19 | $356.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $194.52 / $249.42 / $249.42
| Professional | 50 | $194.52 | $249.42 | $249.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,000.00 / $81,499.99 / $94,999.99
| Facility | | $47,000.00 | $81,499.99 | $94,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.72 / $228.72 / $344.92
| Professional | | $228.72 | $228.72 | $344.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.72 / $228.72 / $228.72
| Facility | | $228.72 | $228.72 | $228.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.91 / $222.07 / $344.92
| Professional | | $146.91 | $222.07 | $344.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.60 / $147.79 / $255.88
| Facility | | $84.60 | $147.79 | $255.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.86 / $228.72 / $352.64
| Professional | | $146.86 | $228.72 | $352.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.00 / $200.00 / $200.00
| Facility | | $200.00 | $200.00 | $200.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.57 / $352.05 / $406.68
| Professional | | $290.57 | $352.05 | $406.68 |