- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $2,238.72 / $6,918.31
| Facility | | $537.03 | $2,238.72 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $169.82 / $323.59
| Professional | | $87.10 | $169.82 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $162.18
| Professional | | $42.66 | $42.66 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $190.55 / $812.83
| Facility | | $120.23 | $190.55 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $147.91 / $234.42
| Professional | | $83.18 | $147.91 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $79.43
| Facility | | $35.48 | $35.48 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $177.83 / $177.83
| Facility | | $177.83 | $177.83 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $181.97 / $331.13
| Professional | | $97.72 | $181.97 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $1,659.59
| Facility | | $54.95 | $56.23 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,412.54 / $1,412.54
| Professional | | $1,202.26 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $218.78 / $3,311.31
| Facility | | $95.50 | $218.78 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $173.78 / $316.23
| Professional | | $91.20 | $173.78 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $75.86
| Professional | | $32.36 | $33.11 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $407.38 / $467.74
| Professional | | $5.01 | $407.38 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $169.82 / $316.23
| Facility | | $89.13 | $169.82 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $186.21 / $331.13
| Professional | | $97.72 | $186.21 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $891.25 / $2,290.87
| Facility | | $173.78 | $891.25 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $151.36 / $251.19
| Professional | | $89.13 | $151.36 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $169.82 / $169.82
| Professional | | $162.18 | $169.82 | $169.82 |