- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.47 / $48.47 / $48.47
| Facility | | $48.47 | $48.47 | $48.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.47 / $51.16 / $61.37
| Professional | | $48.47 | $51.16 | $61.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.00 / $60.00 / $1,500.00
| Professional | | $60.00 | $60.00 | $1,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.22 / $39.21 / $54.31
| Facility | | $27.22 | $39.21 | $54.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,800,000.00 / $2,250,000.00 / $2,250,000.00
| Professional | | $1,800,000.00 | $2,250,000.00 | $2,250,000.00 |