- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $2,238.72 / $3,801.89
| Facility | | $245.47 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $229.09 / $457.09
| Professional | | $138.04 | $229.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $1,905.46 / $5,623.41
| Facility | | $56.23 | $1,905.46 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $281.84 / $1,621.81
| Professional | | $154.88 | $281.84 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $165.96 / $380.19
| Facility | | $165.96 | $165.96 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $1,659.59 / $1,659.59
| Professional | | $1,621.81 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $331.13 / $501.19
| Facility | | $199.53 | $331.13 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $302.00 / $588.84
| Professional | | $173.78 | $302.00 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $190.55 / $3,311.31
| Facility | | $123.03 | $190.55 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $316.23 / $478.63
| Professional | | $223.87 | $316.23 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $281.84 / $575.44
| Professional | | $154.88 | $281.84 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $1,905.46 / $5,623.41
| Facility | | $56.23 | $1,905.46 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $281.84 / $1,621.81
| Professional | | $154.88 | $281.84 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $2,951.21 / $8,511.38
| Facility | | $616.60 | $2,951.21 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $302.00 / $602.56
| Professional | | $154.88 | $302.00 | $602.56 |