- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $1,819.70 / $10,964.78
| Facility | | $125.89 | $1,819.70 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $151.36 / $436.52
| Professional | | $58.88 | $151.36 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $4,365.16 / $8,709.64
| Facility | | $3,090.30 | $4,365.16 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $204.17 / $363.08
| Professional | | $93.33 | $204.17 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $263.03
| Facility | | $158.49 | $158.49 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $208.93 / $457.09
| Professional | | $104.71 | $208.93 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $223.87 / $1,445.44
| Facility | | $102.33 | $223.87 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $204.17 / $398.11
| Professional | | $104.71 | $204.17 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $56.23
| Professional | | $32.36 | $33.11 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $309.03 / $316.23
| Facility | | $190.55 | $309.03 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $213.80
| Facility | | $208.93 | $208.93 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $213.80 / $389.05
| Professional | | $91.20 | $213.80 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,466.84 / $8,709.64
| Facility | | $2,951.21 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $204.17 / $363.08
| Professional | | $95.50 | $204.17 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $5,128.61 / $9,332.54
| Facility | | $1,096.48 | $5,128.61 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $199.53 / $389.05
| Professional | | $83.18 | $199.53 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $114.82 / $245.47
| Professional | | $60.26 | $114.82 | $245.47 |