- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,314.90 / $3,141.05 / $3,498.34
| Professional | | $2,314.90 | $3,141.05 | $3,498.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $399.61 / $494.00 / $758.71
| Facility | | $399.61 | $494.00 | $758.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.54 / $399.61 / $593.63
| Professional | | $266.54 | $399.61 | $593.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.07 / $511.06 / $2,920.33
| Facility | | $376.07 | $511.06 | $2,920.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.29 / $389.33 / $2,400,000.00
| Professional | | $60.29 | $389.33 | $2,400,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.68 / $1,672.75 / $2,937.65
| Professional | | $302.68 | $1,672.75 | $2,937.65 |