- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.59 / $7,119.04 / $19,276.96
| Facility | | $624.59 | $7,119.04 | $19,276.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.98 / $392.12 / $1,806.00
| Professional | | $359.98 | $392.12 | $1,806.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,609.82 / $6,063.17 / $11,728.12
| Facility | | $4,609.82 | $6,063.17 | $11,728.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.63 / $624.96 / $833.27
| Professional | | $366.63 | $624.96 | $833.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.85 / $1,802.85 / $1,802.85
| Facility | | $1,802.85 | $1,802.85 | $1,802.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.00 / $916.58 / $1,228.78
| Professional | | $583.00 | $916.58 | $1,228.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.54 / $681.37 / $4,767.99
| Facility | | $378.54 | $681.37 | $4,767.99 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $106.84 / $646.16 / $646.16
| Facility | AS | $106.84 | $646.16 | $646.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.55 / $831.15 / $1,139.43
| Professional | | $502.55 | $831.15 | $1,139.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $623.04 / $1,024.30 / $2,256.42
| Facility | | $623.04 | $1,024.30 | $2,256.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $623.04 / $906.44 / $1,228.78
| Professional | | $623.04 | $906.44 | $1,228.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.55 / $831.15 / $1,082.42
| Professional | | $502.55 | $831.15 | $1,082.42 |