- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.51 / $6,408.55 / $16,762.57
| Facility | | $823.51 | $6,408.55 | $16,762.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.47 / $823.51 / $2,570.46
| Professional | | $463.47 | $823.51 | $2,570.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.13 / $448.85 / $978.01
| Professional | | $131.13 | $448.85 | $978.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,362.84 / $10,999.42 / $21,276.43
| Facility | | $8,362.84 | $10,999.42 | $21,276.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.29 / $989.67 / $1,679.73
| Professional | | $512.29 | $989.67 | $1,679.73 |
- 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
- $995.23 / $1,591.79 / $2,550.58
| Professional | | $995.23 | $1,591.79 | $2,550.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.36 / $1,029.39 / $2,437.23
| Facility | | $571.36 | $1,029.39 | $2,437.23 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $237.82 / $237.82 / $237.82
| Facility | AS | $237.82 | $237.82 | $237.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,042.33 / $1,693.79 / $4,785.00
| Professional | | $1,042.33 | $1,693.79 | $4,785.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,143.35 / $1,914.84 / $2,842.49
| Facility | | $1,143.35 | $1,914.84 | $2,842.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,089.51 / $1,454.32 / $2,370.83
| Professional | | $1,089.51 | $1,454.32 | $2,370.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $552.79 / $963.84 / $1,770.50
| Professional | | $552.79 | $963.84 | $1,770.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,056.77 / $1,693.79 / $2,291.39
| Professional | | $1,056.77 | $1,693.79 | $2,291.39 |