- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $1,778.28 / $7,244.36
| Facility | | $338.84 | $1,778.28 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $457.09 / $1,621.81
| Professional | | $181.97 | $457.09 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $363.08 / $363.08
| Professional | | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $489.78
| Professional | | $380.19 | $380.19 | $489.78 |
- 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
- $398.11 / $616.60 / $691.83
| Professional | | $398.11 | $616.60 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $380.19 / $645.65
| Professional | | $177.83 | $380.19 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $269.15 / $691.83
| Professional | | $23.99 | $269.15 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $457.09 / $660.69
| Professional | | $251.19 | $457.09 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $229.09 / $2,137.96
| Facility | | $134.90 | $229.09 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $398.11 / $446.68
| Professional | | $186.21 | $398.11 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $407.38
| Professional | | $380.19 | $380.19 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,819.70 / $6,606.93
| Facility | | $478.63 | $1,819.70 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $354.81 / $691.83
| Professional | | $169.82 | $354.81 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $660.69 / $1,548.82
| Professional | | $269.15 | $660.69 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $371.54 / $398.11
| Facility | | $186.21 | $371.54 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $389.05 / $407.38
| Professional | | $186.21 | $389.05 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $575.44 / $4,466.84
| Facility | | $162.18 | $575.44 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $331.13 / $602.56
| Professional | | $169.82 | $331.13 | $602.56 |