- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,305,090.00 / $1,305,090.00 / $1,406,350.00
| Facility | | $1,305,090.00 | $1,305,090.00 | $1,406,350.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $585,039.71 / $655,379.00
| Professional | | $562,538.18 | $585,039.71 | $655,379.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.03 / $0.03
| Facility | | $0.02 | $0.03 | $0.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $562,538.18 / $562,538.18
| Professional | | $562,538.18 | $562,538.18 | $562,538.18 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $562,538.18 / $562,538.18
| Professional | | $562,538.18 | $562,538.18 | $562,538.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,305,090.00 / $1,305,090.00 / $1,406,350.00
| Facility | | $1,305,090.00 | $1,305,090.00 | $1,406,350.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $590,665.09 / $909,948.00
| Professional | | $562,538.18 | $590,665.09 | $909,948.00 |
- 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 |