- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.59 / $182.85 / $5,588.57
| Professional | | $164.59 | $182.85 | $5,588.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.98 / $68,999.99 / $94,999.99
| Facility | | $179.98 | $68,999.99 | $94,999.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.41 / $186.41 / $507.95
| Facility | | $186.41 | $186.41 | $507.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.59 / $164.59 / $186.41
| Professional | | $164.59 | $164.59 | $186.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.41 / $186.41 / $507.95
| Facility | | $186.41 | $186.41 | $507.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.59 / $178.56 / $232.91
| Professional | | $164.59 | $178.56 | $232.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.59 / $164.59 / $164.59
| Professional | | $164.59 | $164.59 | $164.59 |