- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.64 / $83.47 / $83.47
| Professional | | $61.64 | $83.47 | $83.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.20 / $385.20 / $385.20
| Professional | | $385.20 | $385.20 | $385.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.00 / $70.00 / $1,500.00
| Professional | | $60.00 | $70.00 | $1,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.47 / $83.47 / $132.83
| Facility | | $83.47 | $83.47 | $132.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.20 / $385.20 / $2,250,000.00
| Professional | | $385.20 | $385.20 | $2,250,000.00 |