- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.42 / $6,021.16 / $8,413.00
| Facility | | $596.42 | $6,021.16 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.38 / $445.04 / $1,179.42
| Professional | | $379.38 | $445.04 | $1,179.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.89 / $1,794.89 / $1,821.08
| Facility | | $1,794.89 | $1,794.89 | $1,821.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.88 / $689.71 / $1,166.34
| Professional | | $426.88 | $689.71 | $1,166.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,062.80
| Facility | | $606.10 | $606.10 | $2,062.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $462.15 / $613.33 / $1,060.53
| Professional | | $462.15 | $613.33 | $1,060.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $411.63 / $530.04 / $776.56
| Facility | | $411.63 | $530.04 | $776.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $74.20 / $74.20 / $136.00
| Facility | AS | $74.20 | $74.20 | $136.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $520.00 / $520.00 / $544.00
| Professional | | $520.00 | $520.00 | $544.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $553.29 / $1,120.80
| Professional | | $3.00 | $553.29 | $1,120.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $365.82 / $522.42 / $1,091.89
| Professional | | $365.82 | $522.42 | $1,091.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $5,950.27 / $6,817.20
| Facility | | $55.00 | $5,950.27 | $6,817.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $95.10 / $388.48 / $646.16
| Facility | AS | $95.10 | $388.48 | $646.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,034.96 / $3,658.58 / $3,658.58
| Professional | | $3,034.96 | $3,658.58 | $3,658.58 |