- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $812.83 / $977.24
| Professional | | $676.08 | $812.83 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $1,000,000.00
| Facility | | $151,356.12 | $151,356.12 | $1,000,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,348.96 / $1,778.28
| Professional | | $1,348.96 | $1,348.96 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $575.44
| Facility | | $512.86 | $512.86 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $512.86 / $512.86
| Professional | | $125.89 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $616.60 / $1,230.27
| Facility | | $77.62 | $616.60 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $660.69 / $1,023.29
| Professional | | $467.74 | $660.69 | $1,023.29 |