- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $165.96 / $1,905.46
| Facility | | $40.74 | $165.96 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $158.49 / $302.00
| Professional | | $40.74 | $158.49 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,584.89 / $1,584.89
| Facility | | $1,202.26 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $245.47 / $691.83
| Professional | | $79.43 | $245.47 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $602.56 / $954.99
| Facility | | $512.86 | $602.56 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $144.54 / $562.34
| Professional | | $77.62 | $144.54 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $2,398.83 / $4,265.80
| Facility | | $48.98 | $2,398.83 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $169.82 / $549.54
| Professional | | $104.71 | $169.82 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $912.01 / $1,778.28
| Facility | | $53.70 | $912.01 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $363.08 / $851.14
| Professional | | $204.17 | $363.08 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $151.36
| Professional | | $32.36 | $33.11 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $933.25 / $2,344.23
| Facility | | $831.76 | $933.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $269.15 / $575.44
| Professional | | $134.90 | $269.15 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $199.53 / $602.56
| Professional | | $83.18 | $199.53 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $125.89 / $575.44
| Facility | | $125.89 | $125.89 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $398.11 / $1,318.26
| Professional | | $91.20 | $398.11 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $93.33 / $371.54
| Professional | | $93.33 | $93.33 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $331.13 / $812.83
| Professional | | $104.71 | $331.13 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,584.89 / $2,187.76
| Facility | | $1,023.29 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $204.17 / $707.95
| Professional | | $60.26 | $204.17 | $707.95 |