- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $3,235.94 / $11,748.98
| Facility | | $794.33 | $3,235.94 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $371.54 / $758.58
| Professional | | $218.78 | $371.54 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $380.19 / $478.63
| Professional | | $295.12 | $380.19 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $812.83 / $1,737.80
| Facility | | $478.63 | $812.83 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $363.08 / $575.44
| Professional | | $223.87 | $363.08 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $741.31 / $1,659.59
| Facility | | $257.04 | $741.31 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $302.00 / $512.86
| Professional | | $134.90 | $302.00 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $239.88 / $371.54
| Facility | | $204.17 | $239.88 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $416.87 / $645.65
| Professional | | $269.15 | $416.87 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $45,708.82 / $45,708.82
| Facility | | $2,884.03 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $3,311.31 / $3,311.31
| Professional | | $2,818.38 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $457.09 / $4,365.16
| Facility | | $223.87 | $457.09 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $380.19 / $741.31
| Professional | | $223.87 | $380.19 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $316.23
| Professional | | $32.36 | $33.11 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $363.08 / $575.44
| Facility | | $218.78 | $363.08 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $436.52 / $660.69
| Professional | | $275.42 | $436.52 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $933.25 / $2,238.72
| Facility | | $173.78 | $933.25 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $331.13 / $501.19
| Professional | | $218.78 | $331.13 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $371.54 / $398.11
| Professional | | $371.54 | $371.54 | $398.11 |