- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591,726.19 / $1,124,830.00 / $1,124,830.00
| Facility | | $591,726.19 | $1,124,830.00 | $1,124,830.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $591,726.19 / $591,726.19 / $621,312.51
| Professional | | $591,726.19 | $591,726.19 | $621,312.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.03 / $0.04
| Facility | | $0.02 | $0.03 | $0.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $591,726.19 / $591,726.19 / $603,560.72
| Professional | | $591,726.19 | $591,726.19 | $603,560.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591,726.19 / $591,726.19 / $1,159,783.00
| Facility | | $591,726.19 | $591,726.19 | $1,159,783.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $591,726.19 / $591,726.19 / $591,726.19
| Professional | | $591,726.19 | $591,726.19 | $591,726.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $2.81 / $2.81
| Professional | | $2.81 | $2.81 | $2.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565,623.84 / $565,623.84 / $848,435.76
| Professional | | $565,623.84 | $565,623.84 | $848,435.76 |