- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $5,495.41 / $8,709.64
| Facility | | $1,412.54 | $5,495.41 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $186.21 / $416.87
| Professional | | $70.79 | $186.21 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $263.03 / $676.08
| Facility | | $173.78 | $263.03 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $223.87 / $331.13
| Professional | | $125.89 | $223.87 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- 80
- Typical Low / Median / Typical High
- $20.89 / $50.12 / $53.70
| Professional | 80 | $20.89 | $50.12 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $16.98 / $18.62 / $44.67
| Professional | AS | $16.98 | $18.62 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $208.93 / $346.74
| Professional | | $87.10 | $208.93 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $575.44 / $575.44
| Professional | | $436.52 | $575.44 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $181.97 / $436.52
| Facility | | $72.44 | $181.97 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $190.55 / $380.19
| Professional | | $83.18 | $190.55 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $69.18 / $109.65
| Professional | | $32.36 | $69.18 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $169.82 / $354.81
| Professional | | $117.49 | $169.82 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $154.88 / $354.81
| Professional | | $79.43 | $154.88 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $8,317.64 / $9,332.54
| Facility | | $1,819.70 | $8,317.64 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $194.98 / $371.54
| Professional | | $83.18 | $194.98 | $371.54 |