- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $3,235.94 / $8,912.51
| Facility | | $177.83 | $3,235.94 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $331.13 / $707.95
| Professional | | $158.49 | $331.13 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $588.84 / $1,202.26
| Professional | | $323.59 | $588.84 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $8,709.64
| Facility | | $602.56 | $602.56 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $512.86 / $851.14
| Professional | | $223.87 | $512.86 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $912.01 / $954.99
| Professional | | $912.01 | $912.01 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $436.52 / $831.76
| Facility | | $186.21 | $436.52 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $758.58 / $912.01
| Professional | | $602.56 | $758.58 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $9,332.54 / $14,791.08
| Facility | | $3,467.37 | $9,332.54 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $398.11 / $758.58
| Professional | | $181.97 | $398.11 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26,302.68 / $26,302.68 / $45,708.82
| Facility | | $26,302.68 | $26,302.68 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $2,630.27 / $2,630.27 / $2,630.27
| Facility | AS | $2,630.27 | $2,630.27 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,162.28 / $3,235.94
| Professional | | $3,162.28 | $3,162.28 | $3,235.94 |