- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.99 / $267.12 / $363.90
| Professional | | $146.99 | $267.12 | $363.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.01 / $352.01 / $352.01
| Professional | | $352.01 | $352.01 | $352.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.95 / $292.14 / $329.06
| Professional | | $255.95 | $292.14 | $329.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.42 / $243.42 / $325.88
| Facility | | $243.42 | $243.42 | $325.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.91 / $243.42 / $319.50
| Professional | | $206.91 | $243.42 | $319.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.82 / $417.05 / $1,745.64
| Facility | | $185.82 | $417.05 | $1,745.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.33 / $240.46 / $391.76
| Professional | | $170.33 | $240.46 | $391.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.33 / $205.88 / $468.10
| Professional | | $170.33 | $205.88 | $468.10 |