- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.58 / $94.52 / $165.05
| Professional | | $64.58 | $94.52 | $165.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64,999.99 / $64,999.99 / $89,999.99
| Facility | | $64,999.99 | $64,999.99 | $89,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.89 / $101.51 / $156.16
| Professional | | $89.89 | $101.51 | $156.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.29 / $156.16 / $156.16
| Facility | | $138.29 | $156.16 | $156.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.00 / $117.55 / $201.43
| Professional | | $69.00 | $117.55 | $201.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.53 / $95.85 / $156.16
| Facility | | $77.53 | $95.85 | $156.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.00 / $121.81 / $209.24
| Professional | | $77.00 | $121.81 | $209.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.98 / $132.96 / $188.36
| Professional | | $74.98 | $132.96 | $188.36 |