- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $213.80 / $6,456.54
| Facility | | $85.11 | $213.80 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $147.91 / $363.08
| Professional | | $87.10 | $147.91 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,584.89 / $6,165.95
| Facility | | $1,202.26 | $1,584.89 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $295.12 / $660.69
| Professional | | $162.18 | $295.12 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $537.03 / $851.14
| Facility | | $457.09 | $537.03 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $245.47 / $457.09
| Professional | | $117.49 | $245.47 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $302.00 / $5,128.61
| Facility | | $104.71 | $302.00 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $309.03 / $512.86
| Professional | | $190.55 | $309.03 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $295.12 / $1,659.59
| Facility | | $114.82 | $295.12 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $316.23 / $1,778.28
| Professional | | $177.83 | $316.23 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $323.59
| Professional | | $32.36 | $33.11 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $891.25 / $2,344.23
| Facility | | $218.78 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $398.11 / $537.03
| Professional | | $190.55 | $398.11 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $316.23 / $588.84
| Professional | | $173.78 | $316.23 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $1,995.26 / $1,995.26
| Facility | | $269.15 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $234.42 / $1,905.46
| Professional | | $117.49 | $234.42 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $190.55 / $323.59
| Professional | | $190.55 | $190.55 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $446.68 / $741.31
| Professional | | $239.88 | $446.68 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,659.59 / $2,187.76
| Facility | | $1,023.29 | $1,659.59 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $223.87 / $588.84
| Professional | | $114.82 | $223.87 | $588.84 |