- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537,031.80 / $537,031.80 / $537,031.80
| Facility | | $537,031.80 | $537,031.80 | $537,031.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537,031.80 / $537,031.80 / $616,595.00
| Professional | | $537,031.80 | $537,031.80 | $616,595.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61,659.50 / $74,131.02 / $100,000.00
| Facility | | $61,659.50 | $74,131.02 | $100,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537,031.80 / $537,031.80 / $645,654.23
| Professional | | $537,031.80 | $537,031.80 | $645,654.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501,187.23 / $537,031.80 / $537,031.80
| Facility | | $501,187.23 | $537,031.80 | $537,031.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416,869.38 / $501,187.23 / $602,559.59
| Professional | | $416,869.38 | $501,187.23 | $602,559.59 |