- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $433.77 / $1,060.57 / $1,060.57
| Professional | | $433.77 | $1,060.57 | $1,060.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,050.00 / $1,050.00 / $1,050.00
| Facility | | $1,050.00 | $1,050.00 | $1,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.00 / $60.00 / $500.00
| Professional | | $50.00 | $60.00 | $500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.77 / $1,060.57 / $1,060.57
| Facility | | $433.77 | $1,060.57 | $1,060.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,800,000.00 / $2,250,000.00 / $2,400,000.00
| Professional | | $1,800,000.00 | $2,250,000.00 | $2,400,000.00 |