- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $3,548.13 / $8,317.64
| Facility | | $251.19 | $3,548.13 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $204.17 / $407.38
| Professional | | $134.90 | $204.17 | $407.38 |
- 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
- $208.93 / $208.93 / $223.87
| Professional | | $208.93 | $208.93 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $218.78 / $380.19
| Professional | | $144.54 | $218.78 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $239.88 / $478.63
| Professional | | $30.20 | $239.88 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $281.84 / $380.19
| Professional | | $177.83 | $281.84 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $4,365.16 / $8,912.51
| Facility | | $398.11 | $4,365.16 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $218.78 / $218.78
| Professional | | $147.91 | $218.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $2,454.71 / $8,317.64
| Facility | | $302.00 | $2,454.71 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $218.78 / $446.68
| Professional | | $141.25 | $218.78 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $316.23 / $478.63
| Professional | | $295.12 | $316.23 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $144.54 / $269.15
| Facility | | $75.86 | $144.54 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $144.54 / $269.15
| Professional | | $75.86 | $144.54 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $2,570.40 / $5,495.41
| Facility | | $549.54 | $2,570.40 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $208.93 / $371.54
| Professional | | $131.83 | $208.93 | $371.54 |