- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.02 / $251.58 / $288.24
| Facility | | $227.02 | $251.58 | $288.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.64 / $284.29 / $479.77
| Professional | | $219.64 | $284.29 | $479.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.34 / $335.34 / $335.34
| Facility | | $335.34 | $335.34 | $335.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.80 / $244.80 / $345.40
| Professional | | $244.80 | $244.80 | $345.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.84 / $99,999.99 / $99,999.99
| Facility | | $189.84 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.06 / $385.07 / $547.91
| Professional | | $247.06 | $385.07 | $547.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.36 / $249.79 / $274.76
| Professional | | $162.36 | $249.79 | $274.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.30 / $267.73 / $384.10
| Professional | | $235.30 | $267.73 | $384.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.79 / $249.79 / $321.52
| Professional | | $249.79 | $249.79 | $321.52 |