- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.03 / $390.13 / $446.96
| Facility | | $352.03 | $390.13 | $446.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.37 / $390.13 / $743.99
| Professional | | $297.37 | $390.13 | $743.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.00 / $454.00 / $454.00
| Facility | | $454.00 | $454.00 | $454.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.42 / $331.42 / $483.99
| Professional | | $331.42 | $331.42 | $483.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.27 / $99,999.99 / $99,999.99
| Facility | | $294.27 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.11 / $597.08 / $849.66
| Professional | | $383.11 | $597.08 | $849.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.36 / $374.40 / $411.84
| Professional | | $243.36 | $374.40 | $411.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.27 / $415.04 / $520.01
| Professional | | $327.27 | $415.04 | $520.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.40 / $374.40 / $435.28
| Professional | | $374.40 | $374.40 | $435.28 |