- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787,553.46 / $787,553.46 / $787,553.46
| Facility | | $787,553.46 | $787,553.46 | $787,553.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $573,788.94 / $787,553.46
| Professional | | $562,538.18 | $573,788.94 | $787,553.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451,069.50 / $473,622.98 / $497,553.40
| Facility | | $451,069.50 | $473,622.98 | $497,553.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $532,678.78 / $532,678.78 / $532,678.78
| Professional | | $532,678.78 | $532,678.78 | $532,678.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $563,231.27 / $563,231.27 / $674,814.82
| Professional | | $563,231.27 | $563,231.27 | $674,814.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482,927.59 / $647,122.97 / $838,494.88
| Facility | | $482,927.59 | $647,122.97 | $838,494.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $984,720.00 / $984,720.00 / $984,720.00
| Professional | | $984,720.00 | $984,720.00 | $984,720.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630,059.59 / $630,059.59 / $630,059.59
| Facility | | $630,059.59 | $630,059.59 | $630,059.59 |