- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.72 / $3,908.01 / $13,841.56
| Facility | | $332.72 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.81 / $348.50 / $1,422.00
| Professional | | $316.81 | $348.50 | $1,422.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,009.30 / $3,958.05 / $7,656.16
| Facility | | $3,009.30 | $3,958.05 | $7,656.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.32 / $557.95 / $743.92
| Professional | | $327.32 | $557.95 | $743.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.40 / $1,387.40 / $1,387.40
| Facility | | $1,387.40 | $1,387.40 | $1,387.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $520.96 / $813.38 / $1,059.35
| Professional | | $520.96 | $813.38 | $1,059.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.72 / $594.04 / $4,217.00
| Facility | | $332.72 | $594.04 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $595.60 / $3,107.91 / $3,107.91
| Facility | 62 | $595.60 | $3,107.91 | $3,107.91 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $95.30 / $497.27 / $497.27
| Facility | AS | $95.30 | $497.27 | $497.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.77 / $722.36 / $991.59
| Professional | | $436.77 | $722.36 | $991.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.00 / $911.90 / $1,757.37
| Facility | | $575.00 | $911.90 | $1,757.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $543.00 / $737.90 / $1,059.35
| Professional | | $543.00 | $737.90 | $1,059.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.39 / $685.25 / $1,905.99
| Professional | | $378.39 | $685.25 | $1,905.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.77 / $745.88 / $886.32
| Professional | | $436.77 | $745.88 | $886.32 |