- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533,230.17 / $533,230.17 / $533,230.17
| Facility | | $533,230.17 | $533,230.17 | $533,230.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533,230.17 / $533,230.17 / $586,553.18
| Professional | | $533,230.17 | $533,230.17 | $586,553.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $493,508.40 / $864,421.39 / $1,658,970.11
| Facility | | $493,508.40 | $864,421.39 | $1,658,970.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402,864.00 / $488,472.60 / $503,580.00
| Professional | | $402,864.00 | $488,472.60 | $503,580.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $855,126.27 / $1,471,543.92 / $1,791,512.80
| Facility | | $855,126.27 | $1,471,543.92 | $1,791,512.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508,615.80 / $542,080.00 / $639,546.60
| Professional | | $508,615.80 | $542,080.00 | $639,546.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $737,598.40 / $1,300,992.00 / $1,614,412.80
| Facility | | $737,598.40 | $1,300,992.00 | $1,614,412.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492,800.00 / $503,580.00 / $523,891.46
| Professional | | $492,800.00 | $503,580.00 | $523,891.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.38 / $1.38 / $959,814.31
| Facility | | $1.38 | $1.38 | $959,814.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $957,600.00 / $957,600.00 / $957,600.00
| Professional | | $957,600.00 | $957,600.00 | $957,600.00 |