- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $10,471.29 / $61,659.50
| Facility | | $1,905.46 | $10,471.29 | $61,659.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $1,148.15 / $2,290.87
| Professional | | $794.33 | $1,148.15 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- AS
- Low / Median / High Price
- $61.66 / $457.09 / $645.65
| Professional | AS | $61.66 | $457.09 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $81,283.05 / $95,499.26
| Facility | | $46,773.51 | $81,283.05 | $95,499.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,380.38 / $1,698.24
| Professional | | $1,174.90 | $1,380.38 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,380.38 / $1,380.38
| Facility | | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,445.44 / $1,819.70
| Professional | | $1,047.13 | $1,445.44 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,819.70 / $1,995.26
| Facility | | $1,479.11 | $1,819.70 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,819.70 / $1,995.26
| Professional | | $1,479.11 | $1,819.70 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,122.02 / $1,862.09
| Facility | | $776.25 | $1,122.02 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $1,380.38 / $1,995.26
| Professional | | $79.43 | $1,380.38 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,621.81 / $1,949.84
| Professional | | $1,348.96 | $1,621.81 | $1,949.84 |