- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.94 / $96.35 / $110.40
| Facility | | $86.94 | $96.35 | $110.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.22 / $101.74 / $183.76
| Professional | | $84.22 | $101.74 | $183.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.05 / $147.05 / $147.05
| Facility | | $147.05 | $147.05 | $147.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.35 / $107.35 / $132.12
| Professional | | $107.35 | $107.35 | $132.12 |
- 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
- $94.63 / $147.49 / $209.86
| Professional | | $94.63 | $147.49 | $209.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.88 / $167.88 / $167.88
| Professional | | $167.88 | $167.88 | $167.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.98 / $102.51 / $134.29
| Professional | | $81.98 | $102.51 | $134.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.28 / $114.28 / $209.86
| Professional | | $114.28 | $114.28 | $209.86 |