- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562,538.18 / $562,538.18 / $562,538.18
| Facility | | $562,538.18 | $562,538.18 | $562,538.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $562,538.18 / $655,379.00
| Professional | | $562,538.18 | $562,538.18 | $655,379.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $531,350.25 / $536,663.75 / $664,187.81
| Professional | | $531,350.25 | $536,663.75 | $664,187.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562,538.18 / $871,934.19 / $1,297,276.10
| Facility | | $562,538.18 | $871,934.19 | $1,297,276.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562,538.18 / $984,720.00 / $984,720.00
| Professional | | $562,538.18 | $984,720.00 | $984,720.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514,462.76 / $619,730.74 / $774,728.95
| Facility | | $514,462.76 | $619,730.74 | $774,728.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514,462.76 / $542,264.40 / $568,717.43
| Professional | | $514,462.76 | $542,264.40 | $568,717.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $615,607.81 / $615,607.81 / $615,607.81
| Professional | | $615,607.81 | $615,607.81 | $615,607.81 |