- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.85 / $7,943.37 / $20,928.72
| Facility | | $934.85 | $7,943.37 | $20,928.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.58 / $867.34 / $3,093.87
| Professional | | $550.58 | $867.34 | $3,093.87 |
- 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
- $589.24 / $1,138.30 / $1,914.36
| Professional | | $589.24 | $1,138.30 | $1,914.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,715.25 / $6,715.25 / $6,715.25
| Facility | | $6,715.25 | $6,715.25 | $6,715.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,134.17 / $1,818.52 / $2,909.94
| Professional | | $1,134.17 | $1,818.52 | $2,909.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.96 / $1,168.56 / $2,818.80
| Facility | | $657.96 | $1,168.56 | $2,818.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $275.06 / $275.06 / $275.06
| Facility | AS | $275.06 | $275.06 | $275.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,252.23 / $1,879.69 / $5,137.00
| Professional | | $1,252.23 | $1,879.69 | $5,137.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,322.42 / $2,192.13 / $7,796.27
| Facility | | $1,322.42 | $2,192.13 | $7,796.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,303.25 / $1,779.69 / $2,698.63
| Professional | | $1,303.25 | $1,779.69 | $2,698.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $635.40 / $1,122.45 / $2,019.44
| Professional | | $635.40 | $1,122.45 | $2,019.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $13,566.00
| Facility | | $5,341.00 | $7,441.00 | $13,566.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,252.23 / $1,878.34 / $2,449.19
| Professional | | $1,252.23 | $1,878.34 | $2,449.19 |