- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.78 / $76.04 / $315.00
| Professional | | $65.78 | $76.04 | $315.00 |
- 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
- $159.84 / $159.84 / $159.84
| Professional | | $159.84 | $159.84 | $159.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.86 / $159.84 / $190.00
| Facility | | $135.86 | $159.84 | $190.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.73 / $128.77 / $159.84
| Professional | | $84.73 | $128.77 | $159.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.48 / $97.19 / $159.84
| Facility | | $59.48 | $97.19 | $159.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.95 / $136.57 / $177.31
| Professional | | $90.95 | $136.57 | $177.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.48 / $92.75 / $101.66
| Professional | | $81.48 | $92.75 | $101.66 |