- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $565,868.93 / $1,097,350.00 / $1,233,580.00
| Facility | | $565,868.93 | $1,097,350.00 | $1,233,580.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565,868.94 / $565,868.94 / $669,588.00
| Professional | | $565,868.94 | $565,868.94 | $669,588.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $0.05
| Facility | | $0.02 | $0.02 | $0.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565,868.94 / $565,868.94 / $565,868.94
| Professional | | $565,868.94 | $565,868.94 | $565,868.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599,821.07 / $599,821.07 / $938,663.41
| Facility | | $599,821.07 | $599,821.07 | $938,663.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424,401.71 / $622,455.84 / $758,264.39
| Professional | | $424,401.71 | $622,455.84 | $758,264.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912,729.35 / $912,729.35 / $912,729.35
| Facility | | $912,729.35 | $912,729.35 | $912,729.35 |