- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,920.64 / $6,408.55 / $16,762.57
| Facility | | $3,920.64 | $6,408.55 | $16,762.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.26 / $702.23 / $1,987.00
| Professional | | $385.26 | $702.23 | $1,987.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,896.35 / $6,440.04 / $12,457.11
| Facility | | $4,896.35 | $6,440.04 | $12,457.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.95 / $664.71 / $886.27
| Professional | | $389.95 | $664.71 | $886.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.85 / $1,802.85 / $1,802.85
| Facility | | $1,802.85 | $1,802.85 | $1,802.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $620.00 / $977.19 / $1,310.04
| Professional | | $620.00 | $977.19 | $1,310.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.66 / $724.79 / $4,767.99
| Facility | | $402.66 | $724.79 | $4,767.99 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $113.23 / $646.16 / $646.16
| Facility | AS | $113.23 | $646.16 | $646.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.03 / $884.85 / $1,211.22
| Professional | | $535.03 | $884.85 | $1,211.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $665.80 / $1,090.08 / $2,256.42
| Facility | | $665.80 | $1,090.08 | $2,256.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $665.80 / $966.93 / $1,310.04
| Professional | | $665.80 | $966.93 | $1,310.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.03 / $837.54 / $1,085.70
| Professional | | $535.03 | $837.54 | $1,085.70 |