- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,646.18 / $1,794.32 / $2,149.79
| Professional | | $1,646.18 | $1,794.32 | $2,149.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,273.60 / $8,230.90 / $8,230.90
| Facility | | $2,273.60 | $8,230.90 | $8,230.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,445.49 / $8,445.49 / $8,445.49
| Professional | | $8,445.49 | $8,445.49 | $8,445.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.40 / $2,650.30 / $3,193.60
| Professional | | $27.40 | $2,650.30 | $3,193.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400,000.00 / $2,400,000.00 / $2,400,000.00
| Facility | | $2,400,000.00 | $2,400,000.00 | $2,400,000.00 |
- 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 |