- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.13 / $287.95 / $811.31
| Professional | | $155.13 | $287.95 | $811.31 |
- 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
- $299.70 / $299.70 / $299.70
| Professional | | $299.70 | $299.70 | $299.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.61 / $370.50 / $1,134.70
| Facility | | $298.61 | $370.50 | $1,134.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.16 / $214.02 / $360.96
| Professional | | $176.16 | $214.02 | $360.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.35 / $338.42 / $588.25
| Facility | | $274.35 | $338.42 | $588.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.16 / $255.27 / $357.79
| Professional | | $176.16 | $255.27 | $357.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.51 / $248.43 / $344.79
| Professional | | $234.51 | $248.43 | $344.79 |