- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,355.33 / $19,276.96
| Facility | | $4,083.97 | $8,355.33 | $19,276.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $643.03 / $861.19 / $3,295.00
| Professional | | $643.03 | $861.19 | $3,295.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,609.82 / $6,063.17 / $11,728.12
| Facility | | $4,609.82 | $6,063.17 | $11,728.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $639.52 / $1,090.08 / $1,453.47
| Professional | | $639.52 | $1,090.08 | $1,453.47 |
- 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
- $1,030.00 / $1,615.33 / $2,165.56
| Professional | | $1,030.00 | $1,615.33 | $2,165.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $662.46 / $1,192.43 / $4,236.79
| Facility | | $662.46 | $1,192.43 | $4,236.79 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $185.47 / $646.16 / $646.16
| Facility | AS | $185.47 | $646.16 | $646.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $885.48 / $1,464.45 / $2,001.44
| Professional | | $885.48 | $1,464.45 | $2,001.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,101.00 / $1,789.90 / $2,297.38
| Facility | | $1,101.00 | $1,789.90 | $2,297.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,101.00 / $1,584.23 / $2,165.56
| Professional | | $1,101.00 | $1,584.23 | $2,165.56 |
- 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
- $885.48 / $1,487.52 / $1,907.19
| Professional | | $885.48 | $1,487.52 | $1,907.19 |