- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.97 / $157.34 / $180.26
| Facility | | $141.97 | $157.34 | $180.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.16 / $165.62 / $300.05
| Professional | | $136.16 | $165.62 | $300.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.96 / $227.96 / $227.96
| Facility | | $227.96 | $227.96 | $227.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.41 / $166.41 / $227.96
| Professional | | $166.41 | $166.41 | $227.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.19 / $99,999.99 / $99,999.99
| Facility | | $514.19 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.51 / $342.66 / $918.20
| Professional | | $154.51 | $342.66 | $918.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.31 / $788.18 / $866.99
| Professional | | $512.31 | $788.18 | $866.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.85 / $167.39 / $217.91
| Professional | | $133.85 | $167.39 | $217.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.66 / $788.18 / $788.18
| Professional | | $342.66 | $788.18 | $788.18 |