- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,659.59 / $2,187.76
| Professional | | $1,479.11 | $1,659.59 | $2,187.76 |
- 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
- $2,754.23 / $2,754.23 / $3,630.78
| Professional | | $2,754.23 | $2,754.23 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,398.83 / $2,398.83
| Facility | | $2,041.74 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $2,398.83 / $2,398.83
| Professional | | $251.19 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $269.15 / $1,819.70
| Facility | | $199.53 | $269.15 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $1,318.26 / $1,862.09
| Professional | | $758.58 | $1,318.26 | $1,862.09 |