- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.41 / $3,637.20 / $9,338.46
| Facility | | $331.41 | $3,637.20 | $9,338.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.44 / $575.64 / $2,512.57
| Professional | | $209.44 | $575.64 | $2,512.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $842.00 / $842.00
| Facility | | $842.00 | $842.00 | $842.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.47 / $361.79 / $805.52
| Professional | | $223.47 | $361.79 | $805.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.70 / $366.10 / $433.81
| Professional | | $308.70 | $366.10 | $433.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.89 / $369.75 / $1,204.74
| Facility | | $238.89 | $369.75 | $1,204.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.86 / $329.83 / $1,124.26
| Professional | | $274.86 | $329.83 | $1,124.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.10 / $329.47 / $814.80
| Facility | | $247.10 | $329.47 | $814.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.89 / $425.85 / $2,748.00
| Facility | | $238.89 | $425.85 | $2,748.00 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $65.52 / $65.52 / $65.52
| Facility | 80 | $65.52 | $65.52 | $65.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $55.70 / $55.70 / $55.70
| Facility | AS | $55.70 | $55.70 | $55.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.20 / $365.92 / $524.03
| Professional | | $316.20 | $365.92 | $524.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.27 / $401.93 / $534.99
| Professional | | $314.27 | $401.93 | $534.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.00 / $3,290.00 / $6,216.00
| Facility | | $376.00 | $3,290.00 | $6,216.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.10 / $368.14 / $567.20
| Professional | | $260.10 | $368.14 | $567.20 |