- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.51 / $287.55 / $6,929.68
| Facility | | $220.51 | $287.55 | $6,929.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.32 / $34.94 / $119.70
| Professional | | $18.32 | $34.94 | $119.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.48 / $88.51 / $102.77
| Facility | | $57.48 | $88.51 | $102.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.36 / $35.36 / $35.36
| Professional | | $35.36 | $35.36 | $35.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.48 / $88.51 / $102.77
| Facility | | $57.48 | $88.51 | $102.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.36 / $2,250,000.00 / $2,550,000.00
| Professional | | $35.36 | $2,250,000.00 | $2,550,000.00 |