- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,374.87 / $2,374.87 / $22,572.28
| Facility | | $2,374.87 | $2,374.87 | $22,572.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,374.87 / $2,374.87 / $2,374.87
| Professional | | $2,374.87 | $2,374.87 | $2,374.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.92 / $5,821.21 / $8,577.84
| Facility | | $5,456.92 | $5,821.21 | $8,577.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.00 / $64.00 / $64.00
| Facility | | $64.00 | $64.00 | $64.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $100.00 / $100.00
| Facility | | $80.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,374.87 / $2,374.87 / $3,989.78
| Facility | | $2,374.87 | $2,374.87 | $3,989.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,374.87 / $2,374.87 / $2,374.87
| Professional | | $2,374.87 | $2,374.87 | $2,374.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,374.87 / $2,374.87 / $3,562.31
| Facility | | $2,374.87 | $2,374.87 | $3,562.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,374.87 / $2,250,000.00 / $2,400,000.00
| Professional | | $2,374.87 | $2,250,000.00 | $2,400,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.53 / $109.53 / $109.53
| Professional | | $109.53 | $109.53 | $109.53 |