- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $6,456.54 / $14,454.40
| Facility | | $3,981.07 | $6,456.54 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $18,197.01 / $29,512.09
| Facility | | $12,882.50 | $18,197.01 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $9,332.54 / $15,135.61
| Facility | | $8,128.31 | $9,332.54 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $7,762.47 / $14,454.40
| Facility | | $3,715.35 | $7,762.47 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,073.80 / $9,549.93
| Facility | | $2,570.40 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,762.47 / $10,964.78
| Professional | | $4,897.79 | $7,762.47 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $8,128.31 / $77,624.71
| Facility | | $8,128.31 | $8,128.31 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $812.83 / $812.83 / $7,762.47
| Facility | AS | $812.83 | $812.83 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |