- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,417.94 / $17,725.12 / $25,420.10
| Facility | | $1,417.94 | $17,725.12 | $25,420.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,291.36 / $1,440.14 / $5,510.00
| Professional | | $1,291.36 | $1,440.14 | $5,510.00 |
- Facility/Professional
- Professional
- Modifier
- AS
- Low / Median / High Price
- $100.11 / $263.50 / $786.90
| Professional | AS | $100.11 | $263.50 | $786.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,834.59 / $29,315.91 / $66,228.75
| Facility | | $6,834.59 | $29,315.91 | $66,228.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,527.62 / $4,049.85 / $5,284.45
| Professional | | $2,527.62 | $4,049.85 | $5,284.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,432.98 / $4,870.91 / $11,717.62
| Facility | | $3,432.98 | $4,870.91 | $11,717.62 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $161.91 / $161.91 / $161.91
| Facility | AS | $161.91 | $161.91 | $161.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,573.10 / $4,177.74 / $6,599.38
| Professional | | $2,573.10 | $4,177.74 | $6,599.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,120.89 / $4,453.18 / $9,226.48
| Facility | | $3,120.89 | $4,453.18 | $9,226.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,329.60 / $3,698.00 / $5,582.57
| Professional | | $2,329.60 | $3,698.00 | $5,582.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,556.28 / $2,860.64 / $12,306.27
| Facility | | $1,556.28 | $2,860.64 | $12,306.27 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $365.73 / $365.73 / $365.73
| Facility | AS | $365.73 | $365.73 | $365.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,666.54 / $3,003.29 / $7,307.23
| Professional | | $1,666.54 | $3,003.29 | $7,307.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,677.00 / $11,496.00 / $26,414.00
| Facility | | $5,677.00 | $11,496.00 | $26,414.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,556.82 / $2,766.89 / $5,463.20
| Professional | | $1,556.82 | $2,766.89 | $5,463.20 |