- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $144.54 / $380.19
| Facility | | $66.07 | $144.54 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $95.50 / $213.80
| Professional | | $63.10 | $95.50 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $138.04 / $331.13
| Professional | | $91.20 | $138.04 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $316.23 / $501.19
| Facility | | $269.15 | $316.23 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $263.03 / $436.52
| Professional | | $89.13 | $263.03 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $134.90 / $3,162.28
| Facility | | $67.61 | $134.90 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $190.55 / $281.84
| Professional | | $128.82 | $190.55 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $141.25 / $1,584.89
| Facility | | $69.18 | $141.25 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $190.55 / $758.58
| Professional | | $95.50 | $190.55 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $89.13
| Professional | | $32.36 | $33.11 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $891.25 / $2,344.23
| Facility | | $141.25 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $208.93 / $316.23
| Professional | | $128.82 | $208.93 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $223.87 / $380.19
| Professional | | $131.83 | $223.87 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $257.04 / $1,288.25
| Facility | | $138.04 | $257.04 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $467.74 / $741.31
| Professional | | $123.03 | $467.74 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $218.78 / $316.23
| Professional | | $218.78 | $218.78 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $436.52 / $645.65
| Professional | | $186.21 | $436.52 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,584.89 / $2,187.76
| Facility | | $977.24 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $131.83 / $346.74
| Professional | | $72.44 | $131.83 | $346.74 |