- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $923.51 / $9,338.46 / $15,192.34
| Facility | | $923.51 | $9,338.46 | $15,192.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.89 / $697.16 / $2,429.00
| Professional | | $434.89 | $697.16 | $2,429.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,211.00 / $2,211.00 / $2,211.00
| Facility | | $2,211.00 | $2,211.00 | $2,211.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.42 / $911.18 / $1,395.15
| Professional | | $559.42 | $911.18 | $1,395.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $869.54 / $1,020.16 / $1,221.93
| Professional | | $869.54 | $1,020.16 | $1,221.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.20 / $902.12 / $1,285.66
| Facility | | $652.20 | $902.12 | $1,285.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $766.95 / $844.44 / $1,434.45
| Professional | | $766.95 | $844.44 | $1,434.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.50 / $907.85 / $954.08
| Facility | | $656.50 | $907.85 | $954.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.20 / $974.30 / $1,285.66
| Facility | | $652.20 | $974.30 | $1,285.66 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $153.11 / $153.11 / $153.11
| Facility | AS | $153.11 | $153.11 | $153.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $834.79 / $956.63 / $1,307.08
| Professional | | $834.79 | $956.63 | $1,307.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,868.81 / $5,124.10 / $6,421.06
| Facility | | $3,868.81 | $5,124.10 | $6,421.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $867.81 / $1,111.43 / $1,493.78
| Professional | | $867.81 | $1,111.43 | $1,493.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $9,074.00 / $12,786.00
| Facility | | $1,981.00 | $9,074.00 | $12,786.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $667.38 / $960.21 / $1,461.80
| Professional | | $667.38 | $960.21 | $1,461.80 |