- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.00 / $2,447.48 / $6,437.87
| Facility | | $592.00 | $2,447.48 | $6,437.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.01 / $332.21 / $1,459.00
| Professional | | $159.01 | $332.21 | $1,459.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.20 / $947.00 / $7,231.00
| Facility | | $376.20 | $947.00 | $7,231.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.28 / $85.28 / $236.38
| Facility | AS | $85.28 | $85.28 | $236.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.88 / $411.36 / $5,110.16
| Professional | | $181.88 | $411.36 | $5,110.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.09 / $322.20 / $500.49
| Professional | | $233.09 | $322.20 | $500.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.21 / $347.10 / $817.96
| Professional | | $217.21 | $347.10 | $817.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.77 / $357.16 / $6,679.00
| Facility | | $170.77 | $357.16 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.11 / $232.15 / $314.30
| Professional | | $192.11 | $232.15 | $314.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.94 / $400.15 / $525.37
| Professional | | $210.94 | $400.15 | $525.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $445.14 / $2,416.69 / $4,594.58
| Facility | | $445.14 | $2,416.69 | $4,594.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.71 / $258.32 / $509.94
| Professional | | $27.71 | $258.32 | $509.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,856.00 / $26,542.00
| Facility | | $627.00 | $1,856.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.28 / $85.28 / $236.38
| Facility | AS | $85.28 | $85.28 | $236.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.50 / $581.77 / $5,110.16
| Professional | | $215.50 | $581.77 | $5,110.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.91 / $418.17 / $1,020.33
| Professional | | $195.91 | $418.17 | $1,020.33 |