- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.62 / $326.54 / $374.12
| Facility | | $303.62 | $326.54 | $374.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.62 / $374.12 / $529.30
| Professional | | $303.62 | $374.12 | $529.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $564.36 / $564.36 / $564.36
| Facility | | $564.36 | $564.36 | $564.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.98 / $411.98 / $564.36
| Professional | | $411.98 | $411.98 | $564.36 |
- 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
- $320.67 / $513.38 / $711.17
| Professional | | $320.67 | $513.38 | $711.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $568.93 / $568.93 / $568.93
| Professional | | $568.93 | $568.93 | $568.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.39 / $354.79 / $502.37
| Professional | | $305.39 | $354.79 | $502.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.98 / $424.98 / $711.17
| Professional | | $424.98 | $424.98 | $711.17 |