- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578,325.00 / $578,325.00 / $665,073.00
| Facility | | $578,325.00 | $578,325.00 | $665,073.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578,325.00 / $597,643.46 / $739,657.75
| Professional | | $578,325.00 | $597,643.46 | $739,657.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $2.81 / $2.81
| Professional | | $2.81 | $2.81 | $2.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $739,657.75 / $946,761.92
| Facility | | $3.31 | $739,657.75 | $946,761.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $591,726.19 / $710,071.44 / $739,657.75
| Professional | | $591,726.19 | $710,071.44 | $739,657.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $897,095.25 / $1,128,603.60
| Professional | | $30.00 | $897,095.25 | $1,128,603.60 |