- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.79 / $258.79 / $522.86
| Facility | | $258.79 | $258.79 | $522.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.79 / $268.74 / $299.48
| Professional | | $258.79 | $268.74 | $299.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.06 / $467.96 / $522.86
| Facility | | $413.06 | $467.96 | $522.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.94 / $319.93 / $441.50
| Professional | | $255.94 | $319.93 | $441.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.43 / $576.50 / $784.29
| Facility | | $444.43 | $576.50 | $784.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.43 / $575.15 / $705.86
| Professional | | $444.43 | $575.15 | $705.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.35 / $373.35 / $522.86
| Facility | | $373.35 | $373.35 | $522.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.55 / $373.35 / $536.34
| Professional | | $272.55 | $373.35 | $536.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.90 / $260.85 / $385.19
| Professional | | $173.90 | $260.85 | $385.19 |