- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $812.83 / $18,620.87
| Facility | | $245.47 | $812.83 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $295.12 / $724.44
| Professional | | $117.49 | $295.12 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $4,073.80 / $8,317.64
| Facility | | $3,090.30 | $4,073.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $398.11 / $724.44
| Professional | | $194.98 | $398.11 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $1,548.82
| Facility | | $933.25 | $933.25 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $389.05 / $891.25
| Professional | | $190.55 | $389.05 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $467.74 / $1,548.82
| Facility | | $190.55 | $467.74 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $407.38 / $912.01
| Professional | | $190.55 | $407.38 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $58.88
| Professional | | $32.36 | $33.11 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $575.44 / $588.84
| Facility | | $354.81 | $575.44 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $416.87 / $416.87
| Facility | | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $416.87 / $758.58
| Professional | | $177.83 | $416.87 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,265.80 / $8,317.64
| Facility | | $2,884.03 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $380.19 / $724.44
| Professional | | $208.93 | $380.19 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $4,897.79 / $8,912.51
| Facility | | $1,445.44 | $4,897.79 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $338.84 / $758.58
| Professional | | $162.18 | $338.84 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $245.47 / $436.52
| Professional | | $128.82 | $245.47 | $436.52 |