- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537,031.80 / $891,250.94 / $1,258,925.41
| Facility | | $537,031.80 | $891,250.94 | $1,258,925.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537,031.80 / $537,031.80 / $602,559.59
| Professional | | $537,031.80 | $537,031.80 | $602,559.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512,861.38 / $537,031.80 / $645,654.23
| Professional | | $512,861.38 | $537,031.80 | $645,654.23 |
- 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
- $251,188.64 / $501,187.23 / $537,031.80
| Professional | | $251,188.64 | $501,187.23 | $537,031.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $5,011.87 / $5,011.87
| Professional | | $39.81 | $5,011.87 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501,187.23 / $537,031.80 / $891,250.94
| Facility | | $501,187.23 | $537,031.80 | $891,250.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478,630.09 / $537,031.80 / $537,031.80
| Professional | | $478,630.09 | $537,031.80 | $537,031.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537,031.80 / $537,031.80 / $537,031.80
| Professional | | $537,031.80 | $537,031.80 | $537,031.80 |