- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,995.26 / $14,454.40
| Facility | | $933.25 | $1,995.26 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $15,488.17 / $26,302.68
| Facility | | $11,481.54 | $15,488.17 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $2,951.21 / $4,897.79
| Facility | | $2,511.89 | $2,951.21 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,905.46 / $5,495.41
| Facility | | $954.99 | $1,905.46 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,995.26 / $15,135.61
| Facility | | $977.24 | $1,995.26 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,137.96 / $3,235.94
| Professional | | $1,412.54 | $2,137.96 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $18,197.01 / $26,915.35
| Facility | | $9,772.37 | $18,197.01 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $2,691.53
| Facility | AS | $1,819.70 | $1,819.70 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $17,782.79
| Facility | | $8,912.51 | $13,803.84 | $17,782.79 |