- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.34 / $229.44 / $262.88
| Facility | | $213.34 | $229.44 | $262.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.34 / $255.87 / $371.93
| Professional | | $213.34 | $255.87 | $371.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $321.50 / $321.50 / $321.50
| Facility | | $321.50 | $321.50 | $321.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.70 / $234.70 / $314.61
| Professional | | $234.70 | $234.70 | $314.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99,999.99 / $99,999.99 / $99,999.99
| Facility | | $99,999.99 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.32 / $375.54 / $499.71
| Professional | | $225.32 | $375.54 | $499.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.76 / $399.76 / $399.76
| Professional | | $399.76 | $399.76 | $399.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.60 / $249.30 / $333.75
| Professional | | $214.60 | $249.30 | $333.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.61 / $298.61 / $499.71
| Professional | | $298.61 | $298.61 | $499.71 |