- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $3,019.95 / $17,782.79
| Facility | | $354.81 | $3,019.95 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $257.04 / $758.58
| Professional | | $162.18 | $257.04 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $8,511.38 / $17,378.01
| Facility | | $5,495.41 | $8,511.38 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $389.05 / $575.44
| Professional | | $257.04 | $389.05 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $630.96 / $851.14
| Facility | | $239.88 | $630.96 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $346.74 / $691.83
| Professional | | $190.55 | $346.74 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $380.19 / $831.76
| Facility | | $213.80 | $380.19 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $354.81 / $616.60
| Professional | | $194.98 | $354.81 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $104.71
| Professional | | $32.36 | $33.11 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $501.19 / $537.03
| Facility | | $309.03 | $501.19 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $346.74 / $346.74
| Facility | | $257.04 | $346.74 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $363.08 / $645.65
| Professional | | $218.78 | $363.08 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $8,912.51 / $17,378.01
| Facility | | $5,888.44 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $398.11 / $575.44
| Professional | | $257.04 | $398.11 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $9,549.93 / $18,620.87
| Facility | | $812.83 | $9,549.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $323.59 / $549.54
| Professional | | $204.17 | $323.59 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $269.15 / $380.19
| Professional | | $169.82 | $269.15 | $380.19 |