- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.57 / $182.78 / $757.15
| Professional | | $138.57 | $182.78 | $757.15 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $263.43 / $263.43 / $263.43
| Professional | | $263.43 | $263.43 | $263.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.43 / $325.64 / $1,007.99
| Facility | | $263.43 | $325.64 | $1,007.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.43 / $178.97 / $321.83
| Professional | | $151.43 | $178.97 | $321.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.72 / $300.63 / $522.55
| Facility | | $240.72 | $300.63 | $522.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.11 / $225.48 / $315.66
| Professional | | $154.11 | $225.48 | $315.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.41 / $217.89 / $306.12
| Professional | | $207.41 | $217.89 | $306.12 |