- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,177.96 / $1,177.96 / $6,368.40
| Facility | | $1,177.96 | $1,177.96 | $6,368.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.22 / $318.22 / $3,172.85
| Professional | | $318.22 | $318.22 | $3,172.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $673.84 / $673.84 / $673.84
| Professional | | $673.84 | $673.84 | $673.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.22 / $318.22 / $922.84
| Facility | | $318.22 | $318.22 | $922.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.22 / $318.22 / $922.84
| Facility | | $318.22 | $318.22 | $922.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $673.84 / $673.84 / $2,250,000.00
| Professional | | $673.84 | $673.84 | $2,250,000.00 |