- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645,654.23 / $912,010.84 / $2,041,737.94
| Facility | | $645,654.23 | $912,010.84 | $2,041,737.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588,843.66 / $616,595.00 / $831,763.77
| Professional | | $588,843.66 | $616,595.00 | $831,763.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831,763.77 / $2,884,031.50 / $4,677,351.41
| Facility | | $831,763.77 | $2,884,031.50 | $4,677,351.41 |
- 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
- 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 |