- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.64 / $440.67 / $504.88
| Facility | | $397.64 | $440.67 | $504.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.48 / $440.67 / $840.39
| Professional | | $341.48 | $440.67 | $840.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.17 / $499.17 / $499.17
| Facility | | $499.17 | $499.17 | $499.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.39 / $364.39 / $499.17
| Professional | | $364.39 | $364.39 | $499.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.36 / $99,999.99 / $99,999.99
| Facility | | $332.36 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.75 / $674.46 / $959.74
| Professional | | $432.75 | $674.46 | $959.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.43 / $468.36 / $515.19
| Professional | | $304.43 | $468.36 | $515.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.55 / $458.82 / $552.29
| Professional | | $349.55 | $458.82 | $552.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.36 / $468.36 / $468.36
| Professional | | $468.36 | $468.36 | $468.36 |