- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $2,089.30 / $10,232.93
| Facility | | $177.83 | $2,089.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $56.23 / $109.65
| Professional | | $43.65 | $56.23 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $40.74 / $50.12
| Professional | | $22.39 | $40.74 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $4,365.16 / $14,125.38
| Facility | | $1,023.29 | $4,365.16 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $40.74 / $66.07
| Professional | | $31.62 | $40.74 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $43.65
| Facility | | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $64.57 / $173.78
| Professional | | $40.74 | $64.57 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $42.66 / $42.66
| Facility | | $40.74 | $42.66 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $63.10 / $104.71
| Professional | | $45.71 | $63.10 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $1,288.25
| Facility | | $54.95 | $56.23 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $54.95
| Facility | 53 | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $562.34 / $562.34
| Professional | | $58.88 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $630.96 / $5,248.07
| Facility | | $52.48 | $630.96 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $61.66 / $112.20
| Professional | | $43.65 | $61.66 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.88
| Professional | | $32.36 | $33.11 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $11,220.18 / $12,882.50
| Facility | | $6,606.93 | $11,220.18 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $147.91 / $154.88
| Professional | | $147.91 | $147.91 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $67.61 / $128.82
| Facility | | $43.65 | $67.61 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $63.10 / $95.50
| Professional | | $45.71 | $63.10 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $954.99 / $3,090.30
| Facility | | $158.49 | $954.99 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $52.48 / $81.28
| Professional | | $38.90 | $52.48 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $41.69
| Professional | | $39.81 | $39.81 | $41.69 |