- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.00 / $348.06 / $478.72
| Professional | | $277.00 | $348.06 | $478.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.88 / $450.88 / $450.88
| Facility | | $450.88 | $450.88 | $450.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.25 / $450.88 / $464.41
| Professional | | $383.25 | $450.88 | $464.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99,999.99 / $99,999.99 / $99,999.99
| Facility | | $99,999.99 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.00 / $612.37 / $669.05
| Professional | | $385.00 | $612.37 | $669.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.12 / $57.20 / $572.08
| Professional | | $51.12 | $57.20 | $572.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.04 / $230.74 / $512.25
| Facility | | $30.04 | $230.74 | $512.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.96 / $339.24 / $470.89
| Professional | | $252.96 | $339.24 | $470.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.89 / $199.89 / $199.89
| Professional | | $199.89 | $199.89 | $199.89 |