- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $204.17 / $14,454.40
| Facility | | $58.88 | $204.17 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $199.53 / $269.15
| Professional | | $64.57 | $199.53 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $323.59 / $933.25
| Professional | | $114.82 | $323.59 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $741.31 / $1,174.90
| Facility | | $630.96 | $741.31 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $208.93 / $707.95
| Professional | | $112.20 | $208.93 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $2,398.83 / $4,265.80
| Facility | | $70.79 | $2,398.83 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $275.42 / $691.83
| Professional | | $151.36 | $275.42 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $912.01 / $1,778.28
| Facility | | $77.62 | $912.01 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $512.86 / $1,148.15
| Professional | | $281.84 | $512.86 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $933.25 / $2,344.23
| Facility | | $831.76 | $933.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $371.54 / $831.76
| Professional | | $112.20 | $371.54 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $288.40 / $776.25
| Professional | | $107.15 | $288.40 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $181.97 / $724.44
| Facility | | $181.97 | $181.97 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $512.86 / $1,698.24
| Professional | | $131.83 | $512.86 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $131.83 / $446.68
| Professional | | $131.83 | $131.83 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $478.63 / $1,148.15
| Professional | | $263.03 | $478.63 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,584.89 / $2,187.76
| Facility | | $1,023.29 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $302.00 / $977.24
| Professional | | $97.72 | $302.00 | $977.24 |