- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $1,336,940.00 / $3,391,460.00
| Facility | | $0.02 | $1,336,940.00 | $3,391,460.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,304.61 / $489,304.61 / $538,235.06
| Professional | | $489,304.61 | $489,304.61 | $538,235.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $489,304.61
| Facility | | $0.02 | $0.02 | $489,304.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,304.61 / $489,304.61 / $733,956.91
| Professional | | $489,304.61 | $489,304.61 | $733,956.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489,304.60 / $489,304.60 / $733,956.90
| Facility | | $489,304.60 | $489,304.60 | $733,956.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,304.61 / $489,304.61 / $611,630.76
| Professional | | $489,304.61 | $489,304.61 | $611,630.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466,620.00 / $489,720.00 / $586,740.00
| Professional | | $466,620.00 | $489,720.00 | $586,740.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89,304.61 / $89,304.61 / $89,304.61
| Professional | | $89,304.61 | $89,304.61 | $89,304.61 |