- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $17,782.79 / $29,512.09
| Facility | | $1,412.54 | $17,782.79 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,862.09 / $6,606.93
| Professional | | $1,318.26 | $1,862.09 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- AS
- Low / Median / High Price
- $181.97 / $380.19 / $1,071.52
| Professional | AS | $181.97 | $380.19 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $34,673.69 / $83,176.38
| Facility | | $8,709.64 | $34,673.69 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $5,128.61 / $12,302.69
| Facility | | $3,630.78 | $5,128.61 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,951.21 / $2,951.21 / $2,951.21
| Facility | 22 | $2,951.21 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $245.47 / $245.47 / $245.47
| Facility | AS | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,511.89 / $4,168.69 / $6,309.57
| Professional | | $2,511.89 | $4,168.69 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $4,897.79 / $9,549.93
| Facility | | $3,981.07 | $4,897.79 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,467.37 / $5,623.41
| Professional | | $2,630.27 | $3,467.37 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $3,801.89 / $14,791.08
| Facility | | $1,548.82 | $3,801.89 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,019.95 / $10,715.19
| Professional | | $1,513.56 | $3,019.95 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $12,589.25 / $28,183.83
| Facility | | $5,370.32 | $12,589.25 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,570.40 / $5,011.87
| Professional | | $1,445.44 | $2,570.40 | $5,011.87 |