- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616,595.00 / $707,945.78 / $954,992.59
| Facility | | $616,595.00 | $707,945.78 | $954,992.59 |
- 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
- $588,843.66 / $588,843.66 / $588,843.66
| Facility | | $588,843.66 | $588,843.66 | $588,843.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549,540.87 / $588,843.66 / $588,843.66
| Facility | | $549,540.87 | $588,843.66 | $588,843.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588,843.66 / $616,595.00 / $933,254.30
| Professional | | $588,843.66 | $616,595.00 | $933,254.30 |