- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489,304.61 / $489,304.61 / $587,664.00
| Facility | | $489,304.61 | $489,304.61 | $587,664.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,304.61 / $489,304.61 / $513,769.84
| Professional | | $489,304.61 | $489,304.61 | $513,769.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488,051.51 / $512,820.00 / $586,740.00
| Professional | | $488,051.51 | $512,820.00 | $586,740.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489,720.00 / $542,080.00 / $625,856.00
| Professional | | $489,720.00 | $542,080.00 | $625,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650,867.43 / $650,993.25 / $969,564.37
| Facility | | $650,867.43 | $650,993.25 | $969,564.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $996,400.00 / $996,400.00 / $996,400.00
| Professional | | $996,400.00 | $996,400.00 | $996,400.00 |