- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $6,456.54 / $18,620.87
| Facility | | $229.09 | $6,456.54 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $158.49 / $323.59
| Professional | | $93.33 | $158.49 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $8,511.38 / $17,378.01
| Facility | | $5,495.41 | $8,511.38 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $234.42 / $302.00
| Professional | | $162.18 | $234.42 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $3,311.31
| Facility | | $1,995.26 | $1,995.26 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $257.04 / $371.54
| Professional | | $154.88 | $257.04 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $295.12 / $8,317.64
| Facility | | $162.18 | $295.12 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $263.03 / $2,691.53
| Professional | | $162.18 | $263.03 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $56.23
| Professional | | $32.36 | $33.11 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $234.42 / $239.88
| Facility | | $141.25 | $234.42 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $165.96
| Facility | | $158.49 | $158.49 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $257.04 / $346.74
| Professional | | $165.96 | $257.04 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $8,912.51 / $17,378.01
| Facility | | $5,888.44 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $234.42 / $316.23
| Professional | | $162.18 | $234.42 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $10,471.29 / $19,054.61
| Facility | | $2,691.53 | $10,471.29 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $177.83 / $331.13
| Professional | | $125.89 | $177.83 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $151.36 / $234.42
| Professional | | $123.03 | $151.36 | $234.42 |