- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.42 / $241.36 / $276.52
| Facility | | $224.42 | $241.36 | $276.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.42 / $275.67 / $391.23
| Professional | | $224.42 | $275.67 | $391.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $364.44 / $364.44 / $364.44
| Facility | | $364.44 | $364.44 | $364.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.04 / $266.04 / $364.44
| Professional | | $266.04 | $266.04 | $364.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.00 / $99,999.99 / $99,999.99
| Facility | | $182.00 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.02 / $369.41 / $525.64
| Professional | | $237.02 | $369.41 | $525.64 |
- 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
- $225.74 / $262.24 / $388.75
| Professional | | $225.74 | $262.24 | $388.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.20 / $260.20 / $312.95
| Professional | | $260.20 | $260.20 | $312.95 |