- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.98 / $254.75 / $328.23
| Professional | | $198.98 | $254.75 | $328.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.44 / $422.48 / $422.48
| Professional | | $348.44 | $422.48 | $422.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.39 / $382.81 / $382.81
| Facility | | $264.39 | $382.81 | $382.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.29 / $382.81 / $611.25
| Professional | | $40.29 | $382.81 | $611.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.05 / $279.76 / $484.60
| Facility | | $56.05 | $279.76 | $484.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.19 / $193.19 / $193.19
| Professional | | $193.19 | $193.19 | $193.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.80 / $504.63 / $863.00
| Professional | | $499.80 | $504.63 | $863.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.54 / $237.52 / $296.89
| Professional | | $216.54 | $237.52 | $296.89 |