- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $3,548.13 / $9,120.11
| Facility | | $269.15 | $3,548.13 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $251.19 / $602.56
| Professional | | $151.36 | $251.19 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $269.15 / $602.56
| Professional | | $213.80 | $269.15 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $6,165.95
| Facility | | $257.04 | $257.04 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $380.19
| Professional | | $257.04 | $257.04 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $3,235.94 / $53,703.18
| Facility | | $309.03 | $3,235.94 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $316.23 / $676.08
| Professional | | $169.82 | $316.23 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $223.87 / $588.84
| Facility | | $181.97 | $223.87 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $245.47 / $489.78
| Professional | | $158.49 | $245.47 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $288.40 / $501.19
| Professional | | $208.93 | $288.40 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $1,096.48 / $2,290.87
| Facility | | $50.12 | $1,096.48 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $323.59 / $323.59
| Professional | | $218.78 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $50,118.72 / $75,857.76
| Facility | | $218.78 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $398.11 / $398.11
| Professional | | $316.23 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,951.21 / $5,754.40
| Facility | | $1,513.56 | $2,951.21 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $229.09 / $537.03
| Professional | | $120.23 | $229.09 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $194.98 / $616.60
| Facility | | $147.91 | $194.98 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $309.03 / $630.96
| Professional | | $208.93 | $309.03 | $630.96 |