- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $3,715.35 / $12,022.64
| Facility | | $181.97 | $3,715.35 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $125.89 / $257.04
| Professional | | $61.66 | $125.89 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $128.82 / $147.91
| Professional | | $125.89 | $128.82 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $512.86 / $1,071.52
| Facility | | $213.80 | $512.86 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $117.49 / $208.93
| Professional | | $64.57 | $117.49 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $112.20 / $141.25
| Facility | | $57.54 | $112.20 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $144.54 / $239.88
| Professional | | $75.86 | $144.54 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $1,584.89
| Facility | | $54.95 | $56.23 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,258.93 / $1,258.93
| Professional | | $1,096.48 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $141.25 / $3,630.78
| Facility | | $61.66 | $141.25 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $131.83 / $269.15
| Professional | | $63.10 | $131.83 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $128.82
| Professional | | $32.36 | $33.11 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $125.89 / $208.93
| Facility | | $60.26 | $125.89 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $144.54 / $251.19
| Professional | | $77.62 | $144.54 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $851.14 / $2,290.87
| Facility | | $173.78 | $851.14 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $114.82 / $186.21
| Professional | | $63.10 | $114.82 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $141.25 / $147.91
| Professional | | $141.25 | $141.25 | $147.91 |