- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537,031.80 / $954,992.59 / $954,992.59
| Facility | | $537,031.80 | $954,992.59 | $954,992.59 |
- 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
- 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
- Professional
- Modifier
- Low / Median / High Price
- $457,088.19 / $537,031.80 / $549,540.87
| Professional | | $457,088.19 | $537,031.80 | $549,540.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537,031.80 / $537,031.80 / $562,341.33
| Facility | | $537,031.80 | $537,031.80 | $562,341.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501,187.23 / $562,341.33 / $588,843.66
| Professional | | $501,187.23 | $562,341.33 | $588,843.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,778.82 / $489,778.82 / $691,830.97
| Professional | | $489,778.82 | $489,778.82 | $691,830.97 |