- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $3,388.44 / $9,332.54
| Facility | | $109.65 | $3,388.44 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $120.23 / $295.12
| Professional | | $45.71 | $120.23 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $102.33
| Professional | | $102.33 | $102.33 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $5,623.41 / $10,964.78
| Facility | | $4,265.80 | $5,623.41 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $95.50 / $134.90
| Professional | | $54.95 | $95.50 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $147.91 / $204.17
| Professional | | $102.33 | $147.91 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $114.82 / $1,778.28
| Facility | | $66.07 | $114.82 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $151.36 / $537.03
| Professional | | $87.10 | $151.36 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $165.96 / $208.93
| Professional | | $117.49 | $165.96 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $158.49 / $165.96
| Professional | | $114.82 | $158.49 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,041.74 / $2,344.23
| Facility | | $2,041.74 | $2,041.74 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,548.82 / $4,466.84
| Facility | | $1,096.48 | $1,548.82 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $117.49 / $169.82
| Professional | | $66.07 | $117.49 | $169.82 |