- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $691.83 / $7,943.28
| Facility | | $371.54 | $691.83 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $338.84 / $724.44
| Professional | | $234.42 | $338.84 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $630.96 / $1,288.25
| Facility | | $426.58 | $630.96 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $549.54 / $758.58
| Professional | | $363.08 | $549.54 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $363.08
| Facility | | $302.00 | $302.00 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $467.74 / $851.14
| Professional | | $263.03 | $467.74 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $380.19 / $724.44
| Facility | | $234.42 | $380.19 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $398.11 / $707.95
| Professional | | $239.88 | $398.11 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $147.91
| Professional | | $32.36 | $33.11 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $537.03 / $588.84
| Facility | | $346.74 | $537.03 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $389.05 / $416.87
| Facility | | $234.42 | $389.05 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $512.86 / $758.58
| Professional | | $380.19 | $512.86 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $660.69 / $1,288.25
| Facility | | $426.58 | $660.69 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $549.54 / $741.31
| Professional | | $363.08 | $549.54 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $851.14 / $1,949.84
| Facility | | $229.09 | $851.14 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $389.05 / $724.44
| Professional | | $288.40 | $389.05 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $426.58 / $660.69
| Professional | | $346.74 | $426.58 | $660.69 |