- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,677.35 / $5,754.40 / $6,918.31
| Professional | | $4,677.35 | $5,754.40 | $6,918.31 |
- 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
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $3,715.35 / $5,370.32
| Facility | | $3,715.35 | $3,715.35 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $3,715.35 / $6,025.60
| Professional | | $776.25 | $3,715.35 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $741.31 / $4,897.79
| Facility | | $549.54 | $741.31 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,388.44 / $4,466.84
| Professional | | $2,089.30 | $3,388.44 | $4,466.84 |