- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $792,216.52 / $792,216.52 / $792,216.52
| Facility | | $792,216.52 | $792,216.52 | $792,216.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565,868.94 / $577,186.31 / $792,216.52
| Professional | | $565,868.94 | $577,186.31 | $792,216.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451,069.50 / $473,622.98 / $497,553.40
| Facility | | $451,069.50 | $473,622.98 | $497,553.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556,698.72 / $556,698.72 / $556,698.72
| Professional | | $556,698.72 | $556,698.72 | $556,698.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506,965.14 / $695,834.50 / $756,341.29
| Facility | | $506,965.14 | $695,834.50 | $756,341.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674,866.55 / $674,866.55 / $674,866.55
| Facility | | $674,866.55 | $674,866.55 | $674,866.55 |