- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.59 / $297.52 / $358.79
| Professional | | $203.59 | $297.52 | $358.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.65 / $487.65 / $487.65
| Facility | | $487.65 | $487.65 | $487.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.63 / $359.63 / $359.63
| Professional | | $359.63 | $359.63 | $359.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $70.00 / $1,500.00
| Professional | | $32.34 | $70.00 | $1,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.52 / $469.93 / $934.88
| Facility | | $297.52 | $469.93 | $934.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.63 / $359.63 / $2,250,000.00
| Professional | | $359.63 | $359.63 | $2,250,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.03 / $283.23 / $478.96
| Professional | | $236.03 | $283.23 | $478.96 |