- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $595.64 / $4,639.99 / $7,562.16
| Facility | | $595.64 | $4,639.99 | $7,562.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $539.73 / $733.01 / $5,010.30
| Professional | | $539.73 | $733.01 | $5,010.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,498.60 / $3,936.29 / $7,808.13
| Facility | | $2,498.60 | $3,936.29 | $7,808.13 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,402.57 / $6,679.66 / $11,712.19
| Facility | 50 | $4,402.57 | $6,679.66 | $11,712.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.46 / $1,711.76 / $2,220.41
| Professional | | $1,071.46 | $1,711.76 | $2,220.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,482.46 / $2,103.40 / $5,060.01
| Facility | | $1,482.46 | $2,103.40 | $5,060.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $68.64 / $68.64 / $68.64
| Facility | AS | $68.64 | $68.64 | $68.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,115.45 / $1,776.88 / $2,638.94
| Professional | | $1,115.45 | $1,776.88 | $2,638.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,347.69 / $1,923.01 / $3,984.26
| Facility | | $1,347.69 | $1,923.01 | $3,984.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,009.89 / $1,588.65 / $2,420.07
| Professional | | $1,009.89 | $1,588.65 | $2,420.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $654.53 / $1,239.65 / $5,058.83
| Facility | | $654.53 | $1,239.65 | $5,058.83 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $156.88 / $156.88 / $156.88
| Facility | AS | $156.88 | $156.88 | $156.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $662.50 / $1,265.57 / $2,609.52
| Professional | | $662.50 | $1,265.57 | $2,609.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $4,746.00 / $8,812.00
| Facility | | $2,412.00 | $4,746.00 | $8,812.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $637.84 / $1,159.70 / $2,318.65
| Professional | | $637.84 | $1,159.70 | $2,318.65 |