- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.42 / $757.21 / $903.52
| Facility | | $44.42 | $757.21 | $903.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.10 / $739.37 / $1,015.24
| Professional | | $376.10 | $739.37 | $1,015.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $854.15 / $854.15 / $854.15
| Facility | | $854.15 | $854.15 | $854.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $623.53 / $623.53 / $910.56
| Professional | | $623.53 | $623.53 | $910.56 |
- 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
- $539.09 / $898.49 / $1,446.33
| Professional | | $539.09 | $898.49 | $1,446.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $718.79 / $718.79 / $718.79
| Professional | | $718.79 | $718.79 | $718.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $593.27 / $797.06 / $988.78
| Professional | | $593.27 | $797.06 | $988.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $800.91 / $800.91 / $898.49
| Professional | | $800.91 | $800.91 | $898.49 |