- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $7,244.36 / $19,054.61
| Facility | | $1,445.44 | $7,244.36 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $2,454.71
| Facility | 50 | $2,454.71 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $1,479.11 / $3,311.31
| Professional | | $316.23 | $1,479.11 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- AS
- Low / Median / High Price
- $162.18 / $331.13 / $645.65
| Professional | AS | $162.18 | $331.13 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $1,096.48 / $1,698.24
| Professional | | $165.96 | $1,096.48 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $15,848.93 / $23,442.29
| Facility | | $12,882.50 | $15,848.93 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,187.76 / $3,388.44
| Professional | | $1,778.28 | $2,187.76 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $11,748.98 / $11,748.98
| Facility | | $2,187.76 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,630.27 / $2,630.27 / $2,630.27
| Facility | 22 | $2,630.27 | $2,630.27 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,513.56 / $1,513.56 / $1,513.56
| Facility | 54 | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $218.78 / $218.78 / $218.78
| Facility | AS | $218.78 | $218.78 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,905.46 / $3,548.13
| Professional | | $1,096.48 | $1,905.46 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,606.93 / $12,589.25
| Facility | | $2,511.89 | $6,606.93 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,412.54 / $2,630.27
| Professional | | $1,023.29 | $1,412.54 | $2,630.27 |