- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $565,868.94 / $565,868.94 / $565,868.94
| Facility | | $565,868.94 | $565,868.94 | $565,868.94 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $522,055.50 / $522,055.50 / $652,569.38
| Professional | | $522,055.50 | $522,055.50 | $652,569.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710,745.25 / $890,838.60 / $1,444,318.20
| Facility | | $710,745.25 | $890,838.60 | $1,444,318.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565,868.93 / $565,868.93 / $565,868.93
| Professional | | $565,868.93 | $565,868.93 | $565,868.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550,662.61 / $580,827.76 / $581,047.77
| Facility | | $550,662.61 | $580,827.76 | $581,047.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $545,015.86 / $580,827.76 / $826,977.51
| Professional | | $545,015.86 | $580,827.76 | $826,977.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $619,252.81 / $619,252.81 / $619,252.81
| Professional | | $619,252.81 | $619,252.81 | $619,252.81 |