- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,358.93 / $1,412.59 / $1,779.37
| Professional | | $1,358.93 | $1,412.59 | $1,779.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,977.00 / $1,977.00 / $2,471.25
| Professional | | $1,977.00 | $1,977.00 | $2,471.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,365.29 / $1,773.40 / $2,128.08
| Facility | | $1,365.29 | $1,773.40 | $2,128.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,462.77 / $1,462.77 / $1,462.77
| Professional | | $1,462.77 | $1,462.77 | $1,462.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,365.29 / $1,779.37 / $2,128.08
| Facility | | $1,365.29 | $1,779.37 | $2,128.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,462.77 / $1,800,000.00 / $2,400,000.00
| Professional | | $1,462.77 | $1,800,000.00 | $2,400,000.00 |