- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.48 / $477.75 / $777.06
| Professional | | $460.48 | $477.75 | $777.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.43 / $508.43 / $508.43
| Professional | | $508.43 | $508.43 | $508.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.26 / $777.06 / $1,111.20
| Facility | | $489.26 | $777.06 | $1,111.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.75 / $777.06 / $1,111.20
| Facility | | $477.75 | $777.06 | $1,111.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.43 / $508.43 / $1,800,000.00
| Professional | | $508.43 | $508.43 | $1,800,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $610.14 / $863.40 / $1,640.46
| Professional | | $610.14 | $863.40 | $1,640.46 |