- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.98 / $222.15 / $335.13
| Professional | | $198.98 | $222.15 | $335.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.99 / $339.99 / $513.84
| Professional | | $339.99 | $339.99 | $513.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.81 / $382.81 / $382.81
| Facility | | $382.81 | $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
- Professional
- Modifier
- Low / Median / High Price
- $51.12 / $51.12 / $51.12
| Professional | | $51.12 | $51.12 | $51.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.04 / $216.54 / $389.25
| Professional | | $178.04 | $216.54 | $389.25 |