- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,021.04 / $11,975.30 / $14,718.01
| Facility | | $8,021.04 | $11,975.30 | $14,718.01 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,002.94 / $1,002.94 / $1,002.94
| Facility | 54 | $1,002.94 | $1,002.94 | $1,002.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,255.94 / $1,409.17 / $3,581.36
| Professional | | $1,255.94 | $1,409.17 | $3,581.36 |
- Facility/Professional
- Professional
- Modifier
- AS
- Low / Median / High Price
- $84.59 / $127.14 / $183.87
| Professional | AS | $84.59 | $127.14 | $183.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,555.75 / $18,270.88 / $18,407.91
| Facility | | $17,555.75 | $18,270.88 | $18,407.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,556.46 / $2,812.23 / $3,297.49
| Professional | | $2,556.46 | $2,812.23 | $3,297.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,686.20 / $3,077.70 / $4,099.51
| Professional | | $1,686.20 | $3,077.70 | $4,099.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,337.25 / $2,151.81 / $16,677.00
| Facility | | $1,337.25 | $2,151.81 | $16,677.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,554.60 / $2,462.27 / $3,494.81
| Professional | | $1,554.60 | $2,462.27 | $3,494.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,413.27 / $2,407.55 / $3,109.19
| Professional | | $1,413.27 | $2,407.55 | $3,109.19 |