- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.48 / $401.66 / $460.19
| Facility | | $373.48 | $401.66 | $460.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.48 / $460.19 / $651.08
| Professional | | $373.48 | $460.19 | $651.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $673.11 / $673.11 / $673.11
| Facility | | $673.11 | $673.11 | $673.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.37 / $491.37 / $673.11
| Professional | | $491.37 | $491.37 | $673.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.95 / $99,999.99 / $99,999.99
| Facility | | $302.95 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.45 / $614.76 / $874.78
| Professional | | $394.45 | $614.76 | $874.78 |
- 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
- $375.66 / $436.42 / $657.55
| Professional | | $375.66 | $436.42 | $657.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.20 / $260.20 / $529.34
| Professional | | $260.20 | $260.20 | $529.34 |