- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,024.33 / $3,534.30 / $10,139.98
| Facility | | $1,024.33 | $3,534.30 | $10,139.98 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $12,595.88 / $12,595.88 / $12,595.88
| Facility | 50 | $12,595.88 | $12,595.88 | $12,595.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.61 / $676.01 / $2,218.00
| Professional | | $465.61 | $676.01 | $2,218.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.10 / $699.15 / $879.59
| Professional | | $466.10 | $699.15 | $879.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,678.00 / $3,611.00 / $5,737.00
| Facility | | $1,678.00 | $3,611.00 | $5,737.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.22 / $675.08 / $1,086.42
| Professional | | $478.22 | $675.08 | $1,086.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.21 / $2,120.51 / $3,125.00
| Facility | | $596.21 | $2,120.51 | $3,125.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $58.98 / $58.98 / $58.98
| Facility | AS | $58.98 | $58.98 | $58.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $516.51 / $702.05 / $1,130.83
| Professional | | $516.51 | $702.05 | $1,130.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,459.30 / $9,558.29 / $26,542.00
| Facility | | $2,459.30 | $9,558.29 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $116.52 / $905.99 / $905.99
| Facility | AS | $116.52 | $905.99 | $905.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,067.23 / $4,201.45 / $4,550.47
| Professional | | $4,067.23 | $4,201.45 | $4,550.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $4,021.00 / $7,669.00
| Facility | | $1,120.00 | $4,021.00 | $7,669.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.87 / $656.98 / $1,143.85
| Professional | | $472.87 | $656.98 | $1,143.85 |