- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $643.54 / $5,471.86 / $9,872.32
| Facility | | $643.54 | $5,471.86 | $9,872.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $384.72 / $575.47 / $1,142.03
| Professional | | $384.72 | $575.47 | $1,142.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,427.00 / $7,478.00 / $13,989.00
| Facility | | $4,427.00 | $7,478.00 | $13,989.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.79 / $592.10 / $949.50
| Professional | | $457.79 | $592.10 | $949.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,721.49 / $1,721.49 / $5,422.80
| Facility | | $1,721.49 | $1,721.49 | $5,422.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $455.65 / $703.38 / $1,138.68
| Professional | | $455.65 | $703.38 | $1,138.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.01 / $633.73 / $938.52
| Facility | | $392.01 | $633.73 | $938.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.11 / $746.96 / $1,075.63
| Professional | | $533.11 | $746.96 | $1,075.63 |
- Facility/Professional
- Professional
- Modifier
- 22
- Low / Median / High Price
- $705.21 / $705.21 / $1,003.92
| Professional | 22 | $705.21 | $705.21 | $1,003.92 |
- Facility/Professional
- Professional
- Modifier
- 80
- Low / Median / High Price
- $13.43 / $13.43 / $19.12
| Professional | 80 | $13.43 | $13.43 | $19.12 |
- Facility/Professional
- Professional
- Modifier
- AS
- Low / Median / High Price
- $11.42 / $11.42 / $16.25
| Professional | AS | $11.42 | $11.42 | $16.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,852.00 / $6,118.00 / $11,599.00
| Facility | | $2,852.00 | $6,118.00 | $11,599.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $640.35 / $861.91 / $1,550.80
| Professional | | $640.35 | $861.91 | $1,550.80 |