- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $988.00 / $2,096.25 / $3,693.00
| Facility | | $988.00 | $2,096.25 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.36 / $343.70 / $533.99
| Professional | | $284.36 | $343.70 | $533.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $774.69 / $3,630.26 / $9,039.00
| Facility | | $774.69 | $3,630.26 | $9,039.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.41 / $85.41 / $497.27
| Facility | AS | $85.41 | $85.41 | $497.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.58 / $568.85 / $3,232.86
| Professional | | $312.58 | $568.85 | $3,232.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.40 / $646.00 / $997.37
| Professional | | $468.40 | $646.00 | $997.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.00 / $538.46 / $884.02
| Professional | | $361.00 | $538.46 | $884.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $329.66 / $711.72 / $6,679.00
| Facility | | $329.66 | $711.72 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.28 / $458.23 / $626.30
| Professional | | $378.28 | $458.23 | $626.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.14 / $807.11 / $1,277.58
| Professional | | $407.14 | $807.11 | $1,277.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.35 / $90.35 / $90.35
| Professional | | $90.35 | $90.35 | $90.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,215.96 / $3,997.00 / $12,000.00
| Facility | | $1,215.96 | $3,997.00 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.41 / $85.41 / $497.27
| Facility | AS | $85.41 | $85.41 | $497.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.90 / $602.33 / $3,232.86
| Professional | | $350.90 | $602.33 | $3,232.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.19 / $503.91 / $960.17
| Professional | | $334.19 | $503.91 | $960.17 |