- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533,230.17 / $533,230.17 / $1,460,630.00
| Facility | | $533,230.17 | $533,230.17 | $1,460,630.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533,230.17 / $533,230.17 / $559,891.68
| Professional | | $533,230.17 | $533,230.17 | $559,891.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.17 / $39,999.60 / $870,271.88
| Professional | | $1.17 | $39,999.60 | $870,271.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,702.00 / $502,840.73 / $1,076,058.48
| Facility | | $8,702.00 | $502,840.73 | $1,076,058.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $533,076.48 / $533,076.48
| Professional | | $1.58 | $533,076.48 | $533,076.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395,380.00 / $395,380.00 / $395,380.00
| Facility | | $395,380.00 | $395,380.00 | $395,380.00 |