- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $630.96 / $18,620.87
| Facility | | $354.81 | $630.96 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $302.00 / $645.65
| Professional | | $169.82 | $302.00 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $707.95 / $1,445.44
| Facility | | $549.54 | $707.95 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $457.09 / $776.25
| Professional | | $275.42 | $457.09 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $338.84 / $338.84
| Facility | | $338.84 | $338.84 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $416.87 / $870.96
| Professional | | $213.80 | $416.87 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $354.81 / $776.25
| Facility | | $194.98 | $354.81 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $363.08 / $724.44
| Professional | | $194.98 | $363.08 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $112.20
| Professional | | $32.36 | $33.11 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $537.03 / $645.65
| Facility | | $346.74 | $537.03 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $416.87 / $446.68
| Facility | | $269.15 | $416.87 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $446.68 / $794.33
| Professional | | $257.04 | $446.68 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $741.31 / $1,445.44
| Facility | | $501.19 | $741.31 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $446.68 / $758.58
| Professional | | $263.03 | $446.68 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $954.99 / $2,137.96
| Facility | | $257.04 | $954.99 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $363.08 / $691.83
| Professional | | $218.78 | $363.08 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $380.19 / $524.81
| Professional | | $199.53 | $380.19 | $524.81 |