- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,656.41 / $10,900.00 / $14,552.94
| Facility | | $8,656.41 | $10,900.00 | $14,552.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.25 / $219.34 / $295.62
| Professional | | $183.25 | $219.34 | $295.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.62 / $413.87 / $422.74
| Facility | | $295.62 | $413.87 | $422.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.20 / $185.20 / $264.58
| Professional | | $185.20 | $185.20 | $264.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.00 / $570.00 / $575.00
| Professional | | $500.00 | $570.00 | $575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.62 / $413.87 / $422.74
| Facility | | $295.62 | $413.87 | $422.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.20 / $570.00 / $2,250,000.00
| Professional | | $185.20 | $570.00 | $2,250,000.00 |