- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562,341.33 / $562,341.33 / $1,023,292.99
| Facility | | $562,341.33 | $562,341.33 | $1,023,292.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,341.33 / $562,341.33 / $707,945.78
| Professional | | $562,341.33 | $562,341.33 | $707,945.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524,807.46 / $537,031.80 / $676,082.98
| Professional | | $524,807.46 | $537,031.80 | $676,082.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537,031.80 / $851,138.04 / $1,023,292.99
| Facility | | $537,031.80 | $851,138.04 | $1,023,292.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977,237.22 / $977,237.22 / $977,237.22
| Professional | | $977,237.22 | $977,237.22 | $977,237.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562,341.33 / $562,341.33 / $562,341.33
| Facility | | $562,341.33 | $562,341.33 | $562,341.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61,659.50 / $512,861.38 / $851,138.04
| Professional | | $61,659.50 | $512,861.38 | $851,138.04 |