- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.15 / $90.24 / $114.47
| Professional | | $75.15 | $90.24 | $114.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.53 / $70.53 / $70.53
| Facility | | $70.53 | $70.53 | $70.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.49 / $59.95 / $117.29
| Professional | | $51.49 | $59.95 | $117.29 |
- 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
- $90.18 / $150.30 / $195.51
| Professional | | $90.18 | $150.30 | $195.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.41 / $103.21 / $129.02
| Professional | | $77.41 | $103.21 | $129.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.08 / $86.22 / $128.21
| Professional | | $65.08 | $86.22 | $128.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.15 / $130.15 / $130.15
| Professional | | $130.15 | $130.15 | $130.15 |