- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $524.81 / $17,782.79
| Facility | | $251.19 | $524.81 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $194.98 / $676.08
| Professional | | $112.20 | $194.98 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $537.03 / $1,096.48
| Facility | | $371.54 | $537.03 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $263.03 / $446.68
| Professional | | $162.18 | $263.03 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $275.42 / $549.54
| Professional | | $158.49 | $275.42 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $295.12 / $524.81
| Facility | | $181.97 | $295.12 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $295.12 / $489.78
| Professional | | $181.97 | $295.12 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $79.43
| Professional | | $32.36 | $33.11 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $363.08 / $389.05
| Facility | | $199.53 | $363.08 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $263.03
| Facility | | $257.04 | $257.04 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $263.03 / $478.63
| Professional | | $165.96 | $263.03 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $549.54 / $1,096.48
| Facility | | $371.54 | $549.54 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $263.03 / $407.38
| Professional | | $162.18 | $263.03 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $707.95 / $1,584.89
| Facility | | $186.21 | $707.95 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $239.88 / $436.52
| Professional | | $154.88 | $239.88 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $213.80 / $275.42
| Professional | | $112.20 | $213.80 | $275.42 |