- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.34 / $98.28 / $126.54
| Professional | | $89.34 | $98.28 | $126.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.26 / $68,999.99 / $94,999.99
| Facility | | $218.26 | $68,999.99 | $94,999.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.63 / $145.63 / $346.98
| Facility | | $145.63 | $145.63 | $346.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.34 / $89.34 / $145.63
| Professional | | $89.34 | $89.34 | $145.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.34 / $145.63 / $199.62
| Facility | | $89.34 | $145.63 | $199.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.99 / $160.52 / $169.74
| Professional | | $112.99 | $160.52 | $169.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.34 / $89.34 / $89.34
| Professional | | $89.34 | $89.34 | $89.34 |