- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,836.00 / $7,119.04 / $13,841.56
| Facility | | $1,836.00 | $7,119.04 | $13,841.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.28 / $612.71 / $2,497.48
| Professional | | $496.28 | $612.71 | $2,497.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $498.12 / $814.94 / $1,186.41
| Professional | | $498.12 | $814.94 | $1,186.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,522.03 / $5,947.70 / $11,504.78
| Facility | | $4,522.03 | $5,947.70 | $11,504.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.86 / $819.64 / $1,092.85
| Professional | | $480.86 | $819.64 | $1,092.85 |
- 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
- $993.00 / $1,196.13 / $1,603.57
| Professional | | $993.00 | $1,196.13 | $1,603.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $570.72 / $1,126.32 / $6,279.00
| Facility | | $570.72 | $1,126.32 | $6,279.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $140.08 / $849.00 / $849.00
| Facility | AS | $140.08 | $849.00 | $849.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $654.98 / $1,069.68 / $1,442.95
| Professional | | $654.98 | $1,069.68 | $1,442.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,002.07 / $1,396.75 / $2,961.89
| Facility | | $1,002.07 | $1,396.75 | $2,961.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $907.94 / $1,211.06 / $1,603.57
| Professional | | $907.94 | $1,211.06 | $1,603.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $543.91 / $984.77 / $3,257.00
| Professional | | $543.91 | $984.77 | $3,257.00 |
- 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
- $654.98 / $1,083.23 / $1,410.72
| Professional | | $654.98 | $1,083.23 | $1,410.72 |