- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $329.00 / $329.00 / $329.00
| Facility | | $329.00 | $329.00 | $329.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.91 / $154.47 / $200.81
| Professional | | $136.91 | $154.47 | $200.81 |
- 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
- $284.98 / $284.98 / $284.98
| Professional | | $284.98 | $284.98 | $284.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.98 / $284.98 / $338.75
| Facility | | $284.98 | $284.98 | $338.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.25 / $395.80 / $404.09
| Professional | | $96.25 | $395.80 | $404.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.98 / $284.98 / $338.75
| Facility | | $284.98 | $284.98 | $338.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.99 / $223.25 / $398.01
| Professional | | $153.99 | $223.25 | $398.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.37 / $271.36 / $301.44
| Professional | | $221.37 | $271.36 | $301.44 |