- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.94 / $63.92 / $294.42
| Professional | | $50.94 | $63.92 | $294.42 |
- 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
- Facility
- Modifier
- Low / Median / High Price
- $80.45 / $80.45 / $80.45
| Facility | | $80.45 | $80.45 | $80.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.90 / $80.45 / $137.46
| Professional | | $55.90 | $80.45 | $137.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.88 / $92.98 / $118.05
| Facility | | $53.88 | $92.98 | $118.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.90 / $94.36 / $140.96
| Professional | | $55.90 | $94.36 | $140.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.69 / $104.40 / $115.20
| Professional | | $91.69 | $104.40 | $115.20 |