- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422,940.00 / $1,061,790.00 / $1,629,380.00
| Facility | | $422,940.00 | $1,061,790.00 | $1,629,380.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,304.61 / $489,304.61 / $587,165.53
| Professional | | $489,304.61 | $489,304.61 | $587,165.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $0.04
| Facility | | $0.02 | $0.02 | $0.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,304.61 / $596,951.62 / $1,032,432.72
| Professional | | $489,304.61 | $596,951.62 | $1,032,432.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489,304.60 / $489,304.60 / $831,817.80
| Facility | | $489,304.60 | $489,304.60 | $831,817.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,304.61 / $489,304.61 / $660,561.22
| Professional | | $489,304.61 | $489,304.61 | $660,561.22 |
- 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
- $538,235.07 / $538,235.07 / $538,235.07
| Professional | | $538,235.07 | $538,235.07 | $538,235.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,893.05 / $89,304.61 / $89,304.61
| Professional | | $4,893.05 | $89,304.61 | $89,304.61 |