- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591,726.19 / $591,726.19 / $1,005,930.00
| Facility | | $591,726.19 | $591,726.19 | $1,005,930.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $591,726.19 / $591,726.19 / $597,643.46
| Professional | | $591,726.19 | $591,726.19 | $597,643.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641,967.11 / $697,790.34 / $697,790.34
| Facility | | $641,967.11 | $697,790.34 | $697,790.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $591,726.19 / $591,726.19 / $754,450.90
| Professional | | $591,726.19 | $591,726.19 | $754,450.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591,726.19 / $680,485.10 / $946,761.90
| Facility | | $591,726.19 | $680,485.10 | $946,761.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $591,726.19 / $650,898.81 / $858,002.99
| Professional | | $591,726.19 | $650,898.81 | $858,002.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $2.81 / $542,708.82
| Professional | | $2.81 | $2.81 | $542,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.00 / $45.00 / $752,402.44
| Professional | | $45.00 | $45.00 | $752,402.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591,726.19 / $591,726.19 / $591,726.19
| Facility | | $591,726.19 | $591,726.19 | $591,726.19 |