- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.99 / $288.83 / $873.02
| Facility | | $257.99 | $288.83 | $873.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.00 / $294.11 / $412.78
| Professional | | $245.00 | $294.11 | $412.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.79 / $452.98 / $825.57
| Facility | | $283.79 | $452.98 | $825.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.57 / $271.57 / $271.57
| Professional | | $271.57 | $271.57 | $271.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.60 / $253.60 / $253.60
| Facility | | $253.60 | $253.60 | $253.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.60 / $253.60 / $253.60
| Professional | | $253.60 | $253.60 | $253.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.36 / $257.99 / $368.93
| Facility | | $173.36 | $257.99 | $368.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.49 / $283.79 / $423.10
| Professional | | $193.49 | $283.79 | $423.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.99 / $271.57 / $309.58
| Professional | | $257.99 | $271.57 | $309.58 |