- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533,230.00 / $533,230.17 / $959,538.00
| Facility | | $533,230.00 | $533,230.17 | $959,538.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533,230.17 / $533,230.17 / $639,876.21
| Professional | | $533,230.17 | $533,230.17 | $639,876.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503,580.00 / $533,794.80 / $639,546.60
| Professional | | $503,580.00 | $533,794.80 | $639,546.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.38 / $959,814.31 / $959,814.31
| Facility | | $1.38 | $959,814.31 | $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 |