- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $2,630.27 / $8,317.64
| Facility | | $81.28 | $2,630.27 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $138.04 / $257.04
| Professional | | $70.79 | $138.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $87.10 / $123.03
| Professional | | $66.07 | $87.10 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $660.69 / $3,548.13
| Professional | | $75.86 | $660.69 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $134.90 / $239.88
| Professional | | $72.44 | $134.90 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $165.96 / $446.68
| Professional | | $58.88 | $165.96 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $173.78 / $346.74
| Professional | | $141.25 | $173.78 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $138.04 / $257.04
| Facility | | $75.86 | $138.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $91.20 / $4,073.80
| Facility | | $66.07 | $91.20 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $186.21 / $4,073.80
| Professional | | $107.15 | $186.21 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,162.28 / $5,754.40
| Facility | | $1,737.80 | $3,162.28 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $117.49 / $234.42
| Professional | | $58.88 | $117.49 | $234.42 |