- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.99 / $489.26 / $575.60
| Professional | | $471.99 | $489.26 | $575.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.20 / $565.22 / $1,611.21
| Facility | | $452.20 | $565.22 | $1,611.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.35 / $503.35 / $508.43
| Professional | | $503.35 | $503.35 | $508.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.26 / $508.43 / $528.86
| Facility | | $489.26 | $508.43 | $528.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.43 / $508.43 / $508.43
| Professional | | $508.43 | $508.43 | $508.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.43 / $508.43 / $508.43
| Professional | | $508.43 | $508.43 | $508.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.99 / $489.26 / $489.26
| Professional | | $471.99 | $489.26 | $489.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.43 / $575.60 / $834.62
| Professional | | $508.43 | $575.60 | $834.62 |