- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.01 / $243.82 / $279.33
| Facility | | $220.01 | $243.82 | $279.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.18 / $256.64 / $464.97
| Professional | | $202.18 | $256.64 | $464.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.54 / $387.54 / $387.54
| Facility | | $387.54 | $387.54 | $387.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.89 / $282.89 / $387.54
| Professional | | $282.89 | $282.89 | $387.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.96 / $99,999.99 / $99,999.99
| Facility | | $183.96 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.44 / $373.17 / $531.01
| Professional | | $239.44 | $373.17 | $531.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.28 / $281.97 / $310.16
| Professional | | $183.28 | $281.97 | $310.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.52 / $264.06 / $353.57
| Professional | | $222.52 | $264.06 | $353.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.97 / $281.97 / $295.95
| Professional | | $281.97 | $281.97 | $295.95 |