- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $645.65 / $17,782.79
| Facility | | $323.59 | $645.65 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $229.09 / $512.86
| Professional | | $151.36 | $229.09 | $512.86 |
- 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
- $223.87 / $331.13 / $575.44
| Professional | | $223.87 | $331.13 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $338.84 / $724.44
| Facility | | $223.87 | $338.84 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $363.08 / $691.83
| Professional | | $213.80 | $363.08 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $380.19 / $660.69
| Facility | | $234.42 | $380.19 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $380.19 / $616.60
| Professional | | $239.88 | $380.19 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $107.15
| Professional | | $32.36 | $33.11 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $467.74 / $489.78
| Facility | | $295.12 | $467.74 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $331.13 / $338.84
| Facility | | $177.83 | $331.13 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $338.84 / $616.60
| Professional | | $229.09 | $338.84 | $616.60 |
- 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
- $223.87 / $331.13 / $537.03
| Professional | | $223.87 | $331.13 | $537.03 |
- 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
- $213.80 / $309.03 / $575.44
| Professional | | $213.80 | $309.03 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $275.42 / $346.74
| Professional | | $151.36 | $275.42 | $346.74 |