- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.04 / $314.77 / $360.65
| Facility | | $284.04 | $314.77 | $360.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.39 / $331.35 / $600.29
| Professional | | $272.39 | $331.35 | $600.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.63 / $380.63 / $380.63
| Facility | | $380.63 | $380.63 | $380.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.86 / $277.86 / $392.05
| Professional | | $277.86 | $277.86 | $392.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.80 / $99,999.99 / $99,999.99
| Facility | | $205.80 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.13 / $494.89 / $685.57
| Professional | | $309.13 | $494.89 | $685.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.54 / $313.14 / $344.45
| Professional | | $203.54 | $313.14 | $344.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.39 / $334.96 / $435.98
| Professional | | $274.39 | $334.96 | $435.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.14 / $313.14 / $364.95
| Professional | | $313.14 | $313.14 | $364.95 |