- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489,304.61 / $533,342.02 / $1,126,870.00
| Facility | | $489,304.61 | $533,342.02 | $1,126,870.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,304.61 / $489,304.61 / $567,593.35
| Professional | | $489,304.61 | $489,304.61 | $567,593.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.03 / $0.03 / $0.03
| Facility | | $0.03 | $0.03 | $0.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,304.61 / $489,304.61 / $489,304.61
| Professional | | $489,304.61 | $489,304.61 | $489,304.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,720.00 / $489,720.00 / $586,740.00
| Professional | | $489,720.00 | $489,720.00 | $586,740.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460,152.00 / $530,849.34 / $554,400.00
| Professional | | $460,152.00 | $530,849.34 | $554,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508,968.99 / $508,968.99 / $508,968.99
| Facility | | $508,968.99 | $508,968.99 | $508,968.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,304.61 / $489,304.61 / $489,304.61
| Professional | | $489,304.61 | $489,304.61 | $489,304.61 |