- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.38 / $220.38 / $23,876.00
| Facility | | $220.38 | $220.38 | $23,876.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.02 / $283.98 / $1,509.57
| Professional | | $217.02 | $283.98 | $1,509.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.73 / $1,089.00 / $4,952.00
| Facility | | $236.73 | $1,089.00 | $4,952.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $50.90 / $50.90 / $102.06
| Facility | AS | $50.90 | $50.90 | $102.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.21 / $426.63 / $1,876.09
| Professional | | $215.21 | $426.63 | $1,876.09 |
- 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
- $301.30 / $442.71 / $786.81
| Professional | | $301.30 | $442.71 | $786.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.64 / $314.98 / $6,679.00
| Facility | | $209.64 | $314.98 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.56 / $303.02 / $517.88
| Professional | | $240.56 | $303.02 | $517.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.75 / $536.73 / $690.14
| Professional | | $270.75 | $536.73 | $690.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,376.00 / $8,498.00
| Facility | | $55.00 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $50.90 / $50.90 / $102.06
| Facility | AS | $50.90 | $50.90 | $102.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.12 / $448.94 / $1,876.09
| Professional | | $258.12 | $448.94 | $1,876.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.99 / $329.27 / $674.33
| Professional | | $245.99 | $329.27 | $674.33 |