- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.36 / $508.52 / $762.78
| Facility | | $301.36 | $508.52 | $762.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.81 / $391.48 / $508.52
| Professional | | $181.81 | $391.48 | $508.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.09 / $460.09 / $460.09
| Facility | | $460.09 | $460.09 | $460.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.05 / $504.49 / $504.49
| Professional | | $343.05 | $504.49 | $504.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.27 / $304.30 / $603.36
| Facility | | $254.27 | $304.30 | $603.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.54 / $356.99 / $606.53
| Professional | | $156.54 | $356.99 | $606.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.23 / $363.23 / $363.23
| Facility | | $363.23 | $363.23 | $363.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.68 / $180.82 / $361.63
| Professional | | $150.68 | $180.82 | $361.63 |