- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.32 / $188.80 / $240.62
| Professional | | $140.32 | $188.80 | $240.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.80 / $264.32 / $269.98
| Facility | | $188.80 | $264.32 | $269.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.70 / $118.70 / $169.58
| Professional | | $118.70 | $118.70 | $169.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.00 / $415.00 / $420.00
| Professional | | $374.00 | $415.00 | $420.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.80 / $264.32 / $269.98
| Facility | | $188.80 | $264.32 | $269.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.70 / $415.00 / $2,250,000.00
| Professional | | $118.70 | $415.00 | $2,250,000.00 |