- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.99 / $400.99 / $534.22
| Facility | | $400.99 | $400.99 | $534.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.99 / $415.58 / $634.29
| Professional | | $400.99 | $415.58 | $634.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $765.99 / $804.29 / $3,535.81
| Facility | | $765.99 | $804.29 | $3,535.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.99 / $466.53 / $619.72
| Professional | | $425.99 | $466.53 | $619.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.80 / $550.80 / $550.80
| Facility | | $550.80 | $550.80 | $550.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.09 / $402.09 / $567.33
| Professional | | $402.09 | $402.09 | $567.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.99 / $620.00 / $4,148.45
| Facility | | $400.99 | $620.00 | $4,148.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.60 / $382.15 / $931.06
| Professional | | $316.60 | $382.15 | $931.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.44 / $382.15 / $738.54
| Professional | | $294.44 | $382.15 | $738.54 |