- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $3,467.37 / $10,715.19
| Facility | | $109.65 | $3,467.37 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $91.20 / $239.88
| Professional | | $39.81 | $91.20 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $97.72 / $128.82
| Professional | | $35.48 | $97.72 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $125.89 / $524.81
| Facility | | $72.44 | $125.89 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $83.18 / $141.25
| Professional | | $36.31 | $83.18 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $74.13 / $138.04
| Professional | | $54.95 | $74.13 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $97.72 / $104.71
| Facility | | $36.31 | $97.72 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $95.50 / $173.78
| Professional | | $47.86 | $95.50 | $173.78 |
- 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
- $812.83 / $954.99 / $954.99
| Professional | | $812.83 | $954.99 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $104.71 / $3,548.13
| Facility | | $39.81 | $104.71 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $91.20 / $208.93
| Professional | | $39.81 | $91.20 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $97.72
| Professional | | $32.36 | $33.11 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $87.10 / $151.36
| Facility | | $38.02 | $87.10 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $95.50 / $181.97
| Professional | | $48.98 | $95.50 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $851.14 / $2,290.87
| Facility | | $162.18 | $851.14 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $74.13 / $138.04
| Professional | | $38.90 | $74.13 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $112.20
| Professional | | $107.15 | $107.15 | $112.20 |