- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.89 / $130.63 / $140.11
| Professional | | $93.89 | $130.63 | $140.11 |
- 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
- $147.94 / $178.41 / $279.45
| Facility | | $147.94 | $178.41 | $279.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.04 / $174.04 / $337.59
| Professional | | $174.04 | $174.04 | $337.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.53 / $174.04 / $279.45
| Facility | | $116.53 | $174.04 | $279.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.26 / $135.40 / $190.99
| Professional | | $90.26 | $135.40 | $190.99 |