- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $3,388.44 / $9,549.93
| Facility | | $331.13 | $3,388.44 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $549.54 / $1,047.13
| Professional | | $346.74 | $549.54 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $354.81 / $724.44
| Professional | | $177.83 | $354.81 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $3,388.44 / $11,220.18
| Facility | | $776.25 | $3,388.44 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $478.63 / $616.60
| Professional | | $371.54 | $478.63 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,584.89 / $1,698.24
| Facility | | $436.52 | $1,584.89 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $66.07 / $66.07 / $66.07
| Facility | AS | $66.07 | $66.07 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $575.44 / $1,023.29
| Professional | | $363.08 | $575.44 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $13,489.63 / $23,988.33
| Facility | | $6,456.54 | $13,489.63 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $457.09 / $575.44
| Professional | | $281.84 | $457.09 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $316.23 / $776.25
| Professional | | $32.36 | $316.23 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $5,623.41 / $9,772.37
| Facility | | $1,905.46 | $5,623.41 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $478.63 / $912.01
| Professional | | $309.03 | $478.63 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $436.52 / $602.56
| Professional | | $302.00 | $436.52 | $602.56 |