- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $3,090.30 / $7,762.47
| Facility | | $223.87 | $3,090.30 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $218.78 / $537.03
| Professional | | $120.23 | $218.78 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,495.41 / $12,882.50
| Facility | | $3,388.44 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $208.93 / $549.54
| Professional | | $165.96 | $208.93 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $1,698.24 / $6,165.95
| Facility | | $169.82 | $1,698.24 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $169.82 / $302.00
| Professional | | $169.82 | $169.82 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $1,819.70 / $53,703.18
| Facility | | $204.17 | $1,819.70 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $309.03 / $794.33
| Professional | | $151.36 | $309.03 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $144.54 / $407.38
| Facility | | $117.49 | $144.54 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $309.03 / $446.68
| Professional | | $229.09 | $309.03 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $288.40 / $457.09
| Professional | | $181.97 | $288.40 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $50,118.72 / $75,857.76
| Facility | | $128.82 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $316.23 / $457.09
| Professional | | $251.19 | $316.23 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $3,548.13 / $8,709.64
| Facility | | $1,862.09 | $3,548.13 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $229.09 / $575.44
| Professional | | $107.15 | $229.09 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $131.83 / $426.58
| Facility | | $97.72 | $131.83 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $257.04 / $457.09
| Professional | | $173.78 | $257.04 | $457.09 |