- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348,962.88 / $1,479,108.39 / $1,479,108.39
| Facility | | $1,348,962.88 | $1,479,108.39 | $1,479,108.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588,843.66 / $588,843.66 / $616,595.00
| Professional | | $588,843.66 | $588,843.66 | $616,595.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.03 / $0.03
| Facility | | $0.02 | $0.03 | $0.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588,843.66 / $588,843.66 / $588,843.66
| Professional | | $588,843.66 | $588,843.66 | $588,843.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588,843.66 / $588,843.66 / $776,247.12
| Facility | | $588,843.66 | $588,843.66 | $776,247.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588,843.66 / $588,843.66 / $707,945.78
| Professional | | $588,843.66 | $588,843.66 | $707,945.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348,962.88 / $1,348,962.88 / $1,479,108.39
| Facility | | $1,348,962.88 | $1,348,962.88 | $1,479,108.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588,843.66 / $616,595.00 / $912,010.84
| Professional | | $588,843.66 | $616,595.00 | $912,010.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87,096.36 / $87,096.36 / $87,096.36
| Professional | | $87,096.36 | $87,096.36 | $87,096.36 |