- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $1,318.26 / $17,782.79
| Facility | | $87.10 | $1,318.26 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $134.90 / $676.08
| Professional | | $50.12 | $134.90 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $97.72 / $97.72
| Professional | | $97.72 | $97.72 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $154.88 / $302.00
| Professional | | $75.86 | $154.88 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $138.04 / $338.84
| Professional | | $57.54 | $138.04 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $134.90 / $316.23
| Facility | | $67.61 | $134.90 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $134.90 / $316.23
| Professional | | $61.66 | $134.90 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $32.36 / $56.23
| Professional | | $29.51 | $32.36 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $223.87 / $295.12
| Facility | | $165.96 | $223.87 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $162.18 / $162.18
| Facility | | $158.49 | $162.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $158.49 / $295.12
| Professional | | $69.18 | $158.49 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $154.88 / $288.40
| Professional | | $75.86 | $154.88 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $660.69 / $5,754.40
| Facility | | $109.65 | $660.69 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $141.25 / $316.23
| Professional | | $61.66 | $141.25 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $83.18 / $162.18
| Professional | | $43.65 | $83.18 | $162.18 |