- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,317.51 / $13,841.56 / $39,974.00
| Facility | | $1,317.51 | $13,841.56 | $39,974.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,261.68 / $1,331.34 / $5,786.00
| Professional | | $1,261.68 | $1,331.34 | $5,786.00 |
- Facility/Professional
- Professional
- Modifier
- AS
- Low / Median / High Price
- $173.57 / $373.31 / $813.28
| Professional | AS | $173.57 | $373.31 | $813.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,810.84 / $2,541.52 / $25,000.00
| Professional | | $1,810.84 | $2,541.52 | $25,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,999.34 / $17,097.68 / $33,072.44
| Facility | | $12,999.34 | $17,097.68 | $33,072.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,261.64 / $2,150.52 / $2,867.36
| Professional | | $1,261.64 | $2,150.52 | $2,867.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,779.97 / $21,779.97 / $21,779.97
| Facility | | $21,779.97 | $21,779.97 | $21,779.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,276.00 / $3,204.44 / $4,312.92
| Professional | | $2,276.00 | $3,204.44 | $4,312.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,308.09 / $2,485.39 / $18,433.00
| Facility | | $1,308.09 | $2,485.39 | $18,433.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $365.73 / $7,806.31 / $7,806.31
| Facility | AS | $365.73 | $7,806.31 | $7,806.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,759.38 / $2,909.75 / $3,971.97
| Professional | | $1,759.38 | $2,909.75 | $3,971.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,629.14 / $3,520.26 / $27,587.96
| Facility | | $2,629.14 | $3,520.26 | $27,587.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,441.96 / $3,059.13 / $4,312.92
| Professional | | $2,441.96 | $3,059.13 | $4,312.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,759.38 / $2,992.84 / $3,789.44
| Professional | | $1,759.38 | $2,992.84 | $3,789.44 |