- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $3,090.30 / $7,762.47
| Facility | | $331.13 | $3,090.30 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $316.23 / $831.76
| Professional | | $204.17 | $316.23 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $309.03 / $831.76
| Professional | | $234.42 | $309.03 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $6,165.95
| Facility | | $281.84 | $281.84 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $416.87
| Professional | | $281.84 | $281.84 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $4,365.16 / $53,703.18
| Facility | | $34.67 | $4,365.16 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $501.19 / $1,174.90
| Professional | | $218.78 | $501.19 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $213.80 / $478.63
| Facility | | $64.57 | $213.80 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $446.68 / $602.56
| Professional | | $338.84 | $446.68 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $380.19 / $707.95
| Professional | | $213.80 | $380.19 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $50,118.72 / $75,857.76
| Facility | | $3,235.94 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $398.11 / $645.65
| Professional | | $363.08 | $398.11 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,454.71 / $4,897.79
| Facility | | $1,258.93 | $2,454.71 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $338.84 / $724.44
| Professional | | $177.83 | $338.84 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $239.88 / $891.25
| Facility | | $162.18 | $239.88 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $380.19 / $676.08
| Professional | | $213.80 | $380.19 | $676.08 |