- 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 / $645,023.00
| Professional | | $533,230.17 | $533,230.17 | $645,023.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503,580.00 / $508,615.80 / $629,475.00
| Professional | | $503,580.00 | $508,615.80 | $629,475.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.38 / $759,387.73 / $1,231,196.67
| Facility | | $1.38 | $759,387.73 | $1,231,196.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533,230.17 / $957,600.00 / $957,600.00
| Professional | | $533,230.17 | $957,600.00 | $957,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487,957.01 / $603,408.87 / $734,275.73
| Facility | | $487,957.01 | $603,408.87 | $734,275.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487,957.01 / $527,982.76 / $559,730.30
| Professional | | $487,957.01 | $527,982.76 | $559,730.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583,534.90 / $583,534.90 / $583,534.90
| Professional | | $583,534.90 | $583,534.90 | $583,534.90 |