- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,828,250.00 / $1,828,250.00 / $1,828,250.00
| Facility | | $1,828,250.00 | $1,828,250.00 | $1,828,250.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $562,538.18 / $590,665.09
| Professional | | $562,538.18 | $562,538.18 | $590,665.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541,635.66 / $541,635.66 / $572,294.28
| Facility | | $541,635.66 | $541,635.66 | $572,294.28 |
- 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
- $62,538.19 / $62,538.19 / $62,538.19
| Professional | | $62,538.19 | $62,538.19 | $62,538.19 |