- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $1,071.52 / $3,235.94
| Facility | | $89.13 | $1,071.52 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $93.33 / $295.12
| Professional | | $37.15 | $93.33 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $1,348.96 / $3,801.89
| Facility | | $56.23 | $1,348.96 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $112.20 / $309.03
| Professional | | $44.67 | $112.20 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $112.20
| Facility | | $47.86 | $47.86 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $117.49 / $257.04
| Professional | | $47.86 | $117.49 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $141.25 / $302.00
| Professional | | $66.07 | $141.25 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $53.70 / $3,630.78
| Facility | | $39.81 | $53.70 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $138.04 / $190.55
| Professional | | $109.65 | $138.04 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,511.89 / $7,079.46
| Facility | | $1,288.25 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $100.00 / $251.19
| Professional | | $43.65 | $100.00 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $630.96 / $1,318.26
| Facility | | $147.91 | $630.96 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $218.78 / $218.78
| Professional | | $218.78 | $218.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $1,348.96 / $3,801.89
| Facility | | $56.23 | $1,348.96 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $112.20 / $309.03
| Professional | | $44.67 | $112.20 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $2,089.30 / $5,623.41
| Facility | | $954.99 | $2,089.30 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $117.49 / $263.03
| Professional | | $48.98 | $117.49 | $263.03 |