- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.23 / $320.74 / $367.47
| Facility | | $298.23 | $320.74 | $367.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.23 / $367.47 / $519.91
| Professional | | $298.23 | $367.47 | $519.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.76 / $555.76 / $555.76
| Facility | | $555.76 | $555.76 | $555.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.70 / $405.70 / $555.76
| Professional | | $405.70 | $405.70 | $555.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.92 / $99,999.99 / $99,999.99
| Facility | | $241.92 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.97 / $490.89 / $698.54
| Professional | | $314.97 | $490.89 | $698.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.13 / $260.20 / $286.22
| Professional | | $169.13 | $260.20 | $286.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.97 / $348.49 / $525.07
| Professional | | $299.97 | $348.49 | $525.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.20 / $260.20 / $422.69
| Professional | | $260.20 | $260.20 | $422.69 |