- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.75 / $4,319.39 / $8,294.00
| Facility | | $659.75 | $4,319.39 | $8,294.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.70 / $471.77 / $826.89
| Professional | | $390.70 | $471.77 | $826.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.14 / $501.47 / $829.08
| Professional | | $392.14 | $501.47 | $829.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.56 / $454.71 / $3,019.00
| Professional | | $415.56 | $454.71 | $3,019.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.11 / $479.11 / $640.00
| Facility | | $479.11 | $479.11 | $640.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $47.57 / $47.57 / $47.57
| Facility | AS | $47.57 | $47.57 | $47.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $414.14 / $559.16 / $921.60
| Professional | | $414.14 | $559.16 | $921.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.25 / $516.71 / $610.66
| Professional | | $403.25 | $516.71 | $610.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.84 / $551.97 / $781.38
| Facility | | $439.84 | $551.97 | $781.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $74.05 / $79.73 / $151.78
| Facility | AS | $74.05 | $79.73 | $151.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $522.00 / $591.00 / $983.08
| Professional | | $522.00 | $591.00 | $983.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.02 / $535.46 / $1,832.40
| Facility | | $405.02 | $535.46 | $1,832.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.02 / $535.46 / $1,832.40
| Professional | | $405.02 | $535.46 | $1,832.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,651.00 / $6,870.00 / $12,739.00
| Facility | | $3,651.00 | $6,870.00 | $12,739.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.45 / $553.17 / $871.69
| Professional | | $343.45 | $553.17 | $871.69 |