- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $2,344.23 / $10,471.29
| Facility | | $181.97 | $2,344.23 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $281.84 / $1,122.02
| Professional | | $154.88 | $281.84 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $134.90 / $199.53
| Professional | | $18.62 | $134.90 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,760.83 / $22,908.68
| Facility | | $2,454.71 | $6,760.83 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $204.17 / $1,071.52
| Professional | | $162.18 | $204.17 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $213.80 / $275.42
| Facility | | $158.49 | $213.80 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $199.53 / $251.19
| Professional | | $162.18 | $199.53 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $1,862.09
| Facility | | $295.12 | $295.12 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $29.51 / $29.51 / $29.51
| Facility | AS | $29.51 | $29.51 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $758.58 / $4,677.35
| Professional | | $181.97 | $758.58 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $616.60
| Professional | | $32.36 | $33.11 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $724.44 / $1,949.84
| Facility | | $58.88 | $724.44 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $331.13 / $912.01
| Professional | | $154.88 | $331.13 | $912.01 |