- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $3,630.78 / $17,782.79
| Facility | | $426.58 | $3,630.78 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $309.03 / $891.25
| Professional | | $199.53 | $309.03 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $147.91 / $147.91
| Professional | | $147.91 | $147.91 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $4,365.16 / $8,709.64
| Facility | | $3,090.30 | $4,365.16 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $446.68 / $741.31
| Professional | | $302.00 | $446.68 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $416.87 / $724.44
| Facility | | $281.84 | $416.87 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $489.78 / $891.25
| Professional | | $288.40 | $489.78 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $501.19 / $891.25
| Facility | | $309.03 | $501.19 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $501.19 / $776.25
| Professional | | $309.03 | $501.19 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $144.54
| Professional | | $32.36 | $33.11 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $575.44 / $616.60
| Facility | | $331.13 | $575.44 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $426.58 / $436.52
| Facility | | $223.87 | $426.58 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $457.09 / $794.33
| Professional | | $309.03 | $457.09 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,466.84 / $8,709.64
| Facility | | $2,951.21 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $446.68 / $724.44
| Professional | | $309.03 | $446.68 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $4,897.79 / $9,332.54
| Facility | | $912.01 | $4,897.79 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $407.38 / $776.25
| Professional | | $281.84 | $407.38 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $363.08 / $457.09
| Professional | | $213.80 | $363.08 | $457.09 |