- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.69 / $250.18 / $460.24
| Professional | | $243.69 | $250.18 | $460.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64,999.99 / $77,999.99 / $94,999.99
| Facility | | $64,999.99 | $77,999.99 | $94,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.29 / $437.99 / $437.99
| Professional | | $372.29 | $437.99 | $437.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.99 / $437.99 / $520.63
| Facility | | $437.99 | $437.99 | $520.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.44 / $405.65 / $510.11
| Professional | | $256.44 | $405.65 | $510.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.64 / $313.98 / $437.99
| Facility | | $261.64 | $313.98 | $437.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.30 / $412.99 / $545.84
| Professional | | $275.30 | $412.99 | $545.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.53 / $439.64 / $485.12
| Professional | | $387.53 | $439.64 | $485.12 |