- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.69 / $319.93 / $381.74
| Facility | | $288.69 | $319.93 | $381.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.83 / $336.77 / $610.13
| Professional | | $276.83 | $336.77 | $610.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.50 / $437.50 / $437.50
| Facility | | $437.50 | $437.50 | $437.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.38 / $319.38 / $441.05
| Professional | | $319.38 | $319.38 | $441.05 |
- 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
- $327.20 / $545.34 / $1,000.26
| Professional | | $327.20 | $545.34 | $1,000.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.42 / $557.42 / $557.42
| Professional | | $557.42 | $557.42 | $557.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.18 / $347.62 / $484.53
| Professional | | $272.18 | $347.62 | $484.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.47 / $392.47 / $696.78
| Professional | | $392.47 | $392.47 | $696.78 |