- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.38 / $1,030.38 / $23,876.00
| Facility | | $1,030.38 | $1,030.38 | $23,876.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $958.59 / $1,286.67 / $3,694.60
| Professional | | $958.59 | $1,286.67 | $3,694.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.35 / $3,887.00 / $13,017.00
| Facility | | $818.35 | $3,887.00 | $13,017.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $246.73 / $246.73 / $498.72
| Facility | AS | $246.73 | $246.73 | $498.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $871.35 / $1,975.85 / $7,119.84
| Professional | | $871.35 | $1,975.85 | $7,119.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49,922.00 / $52,419.00 / $56,064.00
| Facility | | $49,922.00 | $52,419.00 | $56,064.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,429.35 / $2,090.88 / $3,789.51
| Professional | | $1,429.35 | $2,090.88 | $3,789.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,007.66 / $1,909.00 / $6,679.00
| Facility | | $1,007.66 | $1,909.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,156.29 / $1,461.11 / $2,146.32
| Professional | | $1,156.29 | $1,461.11 | $2,146.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,284.51 / $2,546.41 / $3,233.11
| Professional | | $1,284.51 | $2,546.41 | $3,233.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $6,078.00 / $14,018.00
| Facility | | $55.00 | $6,078.00 | $14,018.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $246.73 / $246.73 / $498.72
| Facility | AS | $246.73 | $246.73 | $498.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,077.63 / $2,177.21 / $7,119.84
| Professional | | $1,077.63 | $2,177.21 | $7,119.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $5,904.00 / $13,017.00
| Facility | | $2,386.00 | $5,904.00 | $13,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $965.20 / $1,574.55 / $3,371.48
| Professional | | $965.20 | $1,574.55 | $3,371.48 |