- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,159.25 / $1,660.45 / $26,160.25
| Facility | | $1,159.25 | $1,660.45 | $26,160.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,303.79 / $3,700.69 / $68,058.30
| Professional | | $1,303.79 | $3,700.69 | $68,058.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,479.00 / $10,355.00 / $24,019.00
| Facility | | $8,479.00 | $10,355.00 | $24,019.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $871.66 / $9,067.32 / $22,003.56
| Professional | | $871.66 | $9,067.32 | $22,003.56 |
- Facility/Professional
- Professional
- Modifier
- 80
- Low / Median / High Price
- $147.80 / $1,520.28 / $3,427.75
| Professional | 80 | $147.80 | $1,520.28 | $3,427.75 |
- Facility/Professional
- Professional
- Modifier
- AS
- Low / Median / High Price
- $129.33 / $1,330.25 / $2,999.28
| Professional | AS | $129.33 | $1,330.25 | $2,999.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,063.08 / $37,466.36 / $76,215.44
| Facility | | $29,063.08 | $37,466.36 | $76,215.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,146.80 / $1,685.09 / $28,401.30
| Professional | | $1,146.80 | $1,685.09 | $28,401.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,844.92 / $36,858.30 / $52,056.34
| Facility | | $25,844.92 | $36,858.30 | $52,056.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14,185.13 / $21,039.60 / $32,673.00
| Professional | | $14,185.13 | $21,039.60 | $32,673.00 |