- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $3,235.94 / $7,762.47
| Facility | | $389.05 | $3,235.94 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $371.54 / $776.25
| Professional | | $229.09 | $371.54 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $213.80
| Professional | | $199.53 | $199.53 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $724.44 / $724.44
| Professional | | $630.96 | $724.44 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $407.38 / $691.83
| Professional | | $269.15 | $407.38 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $645.65 / $707.95
| Professional | | $426.58 | $645.65 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $478.63 / $691.83
| Professional | | $338.84 | $478.63 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $2,089.30 / $3,090.30
| Facility | | $741.31 | $2,089.30 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $407.38 / $436.52
| Professional | | $338.84 | $407.38 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $199.53
| Professional | | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $3,090.30 / $6,760.83
| Facility | | $537.03 | $3,090.30 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $389.05 / $741.31
| Professional | | $251.19 | $389.05 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $724.44 / $1,698.24
| Professional | | $436.52 | $724.44 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $398.11 / $467.74
| Facility | | $316.23 | $398.11 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $398.11 / $467.74
| Professional | | $316.23 | $398.11 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,479.11 / $3,890.45
| Facility | | $363.08 | $1,479.11 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $380.19 / $645.65
| Professional | | $251.19 | $380.19 | $645.65 |