- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.01 / $4,278.21 / $13,841.56
| Facility | | $491.01 | $4,278.21 | $13,841.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.96 / $491.01 / $1,734.40
| Professional | | $327.96 | $491.01 | $1,734.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,712.35 / $6,198.03 / $11,988.99
| Facility | | $4,712.35 | $6,198.03 | $11,988.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.75 / $655.10 / $990.02
| Professional | | $345.75 | $655.10 | $990.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $653.35 / $1,015.94 / $1,493.92
| Professional | | $653.35 | $1,015.94 | $1,493.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.48 / $623.12 / $1,660.48
| Facility | | $382.48 | $623.12 | $1,660.48 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $160.77 / $160.77 / $160.77
| Facility | AS | $160.77 | $160.77 | $160.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $661.91 / $1,122.70 / $2,635.20
| Professional | | $661.91 | $1,122.70 | $2,635.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $772.92 / $1,130.27 / $2,842.49
| Facility | | $772.92 | $1,130.27 | $2,842.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $734.33 / $1,054.07 / $1,430.76
| Professional | | $734.33 | $1,054.07 | $1,430.76 |
- 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
- $661.91 / $1,130.33 / $1,425.65
| Professional | | $661.91 | $1,130.33 | $1,425.65 |