- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $251.19 / $660.69
| Facility | | $186.21 | $251.19 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $208.93 / $426.58
| Professional | | $151.36 | $208.93 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $346.74 / $851.14
| Professional | | $186.21 | $346.74 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $549.54 / $891.25
| Facility | | $478.63 | $549.54 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $398.11 / $645.65
| Professional | | $213.80 | $398.11 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $1,698.24 / $3,801.89
| Facility | | $181.97 | $1,698.24 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $426.58 / $537.03
| Professional | | $316.23 | $426.58 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $1,949.84 / $4,168.69
| Facility | | $181.97 | $1,949.84 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $338.84 / $1,148.15
| Professional | | $190.55 | $338.84 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $251.19
| Professional | | $32.36 | $33.11 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $2,951.21 / $3,235.94
| Facility | | $331.13 | $2,951.21 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $501.19 / $691.83
| Professional | | $251.19 | $501.19 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $446.68 / $660.69
| Professional | | $239.88 | $446.68 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,288.25 / $1,905.46
| Facility | | $1,288.25 | $1,288.25 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $489.78 / $1,318.26
| Professional | | $269.15 | $489.78 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $446.68
| Professional | | $380.19 | $380.19 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $933.25 / $1,096.48
| Professional | | $407.38 | $933.25 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,754.23 / $5,011.87
| Facility | | $2,041.74 | $2,754.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $295.12 / $724.44
| Professional | | $177.83 | $295.12 | $724.44 |