- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,122.02 / $17,782.79
| Facility | | $426.58 | $1,122.02 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $331.13 / $1,023.29
| Professional | | $190.55 | $331.13 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,071.52 / $2,137.96
| Facility | | $758.58 | $1,071.52 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $501.19 / $851.14
| Professional | | $288.40 | $501.19 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $331.13 / $512.86
| Facility | | $331.13 | $331.13 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $489.78 / $1,023.29
| Professional | | $275.42 | $489.78 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $524.81 / $954.99
| Facility | | $309.03 | $524.81 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $524.81 / $891.25
| Professional | | $309.03 | $524.81 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $138.04
| Professional | | $32.36 | $33.11 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $660.69 / $724.44
| Facility | | $346.74 | $660.69 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $489.78 / $501.19
| Facility | | $229.09 | $489.78 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $501.19 / $891.25
| Professional | | $295.12 | $501.19 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,096.48 / $2,137.96
| Facility | | $724.44 | $1,096.48 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $501.19 / $776.25
| Professional | | $288.40 | $501.19 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,380.38 / $2,754.23
| Facility | | $371.54 | $1,380.38 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $436.52 / $812.83
| Professional | | $269.15 | $436.52 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $389.05 / $524.81
| Professional | | $204.17 | $389.05 | $524.81 |