- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $1,478,670.00 / $3,750,990.00
| Facility | | $0.02 | $1,478,670.00 | $3,750,990.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $562,538.18 / $618,792.00
| Professional | | $562,538.18 | $562,538.18 | $618,792.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $562,538.18
| Facility | | $0.02 | $0.02 | $562,538.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $562,538.18 / $843,807.28
| Professional | | $562,538.18 | $562,538.18 | $843,807.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562,538.19 / $562,538.19 / $843,807.30
| Facility | | $562,538.19 | $562,538.19 | $843,807.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $562,538.18 / $703,172.74
| Professional | | $562,538.18 | $562,538.18 | $703,172.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $536,663.75 / $563,231.27 / $674,814.82
| Professional | | $536,663.75 | $563,231.27 | $674,814.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852,129.78 / $1,032,884.58 / $1,032,884.58
| Facility | | $852,129.78 | $1,032,884.58 | $1,032,884.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62,538.19 / $62,538.19 / $62,538.19
| Professional | | $62,538.19 | $62,538.19 | $62,538.19 |