- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.33 / $641.33 / $641.33
| Facility | | $641.33 | $641.33 | $641.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.86 / $641.33 / $641.33
| Professional | | $472.86 | $641.33 | $641.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219,999.78 / $539,999.46 / $949,999.05
| Facility | | $219,999.78 | $539,999.46 | $949,999.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $996.10 / $1,318.37 / $1,464.85
| Professional | | $996.10 | $1,318.37 | $1,464.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,141.28 / $1,141.28 / $1,268.57
| Facility | | $1,141.28 | $1,141.28 | $1,268.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,268.57 / $1,268.57 / $1,268.57
| Professional | | $1,268.57 | $1,268.57 | $1,268.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $713.15 / $713.15 / $923.08
| Facility | | $713.15 | $713.15 | $923.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $520.60 / $713.14 / $901.45
| Professional | | $520.60 | $713.14 | $901.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.58 / $564.29 / $903.03
| Professional | | $379.58 | $564.29 | $903.03 |