- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $2,884.03 / $13,489.63
| Facility | | $295.12 | $2,884.03 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $331.13 / $1,905.46
| Professional | | $154.88 | $331.13 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $144.54 / $169.82
| Professional | | $19.95 | $144.54 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $6,456.54 / $16,218.10
| Facility | | $2,511.89 | $6,456.54 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $346.74 / $1,318.26
| Professional | | $186.21 | $346.74 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $181.97 / $245.47
| Professional | | $154.88 | $181.97 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $9,772.37 / $14,791.08
| Facility | | $6,456.54 | $9,772.37 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $251.19 / $954.99
| Professional | | $177.83 | $251.19 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $446.68 / $8,511.38
| Facility | | $169.82 | $446.68 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $93.33 / $234.42 / $234.42
| Facility | AS | $93.33 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $323.59 / $5,128.61
| Professional | | $165.96 | $323.59 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $707.95 / $6,606.93
| Facility | | $338.84 | $707.95 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $218.78 / $741.31
| Professional | | $154.88 | $218.78 | $741.31 |