- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $2,454.71 / $7,585.78
| Facility | | $537.03 | $2,454.71 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $218.78 / $346.74
| Professional | | $138.04 | $218.78 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $245.47 / $1,023.29
| Facility | | $154.88 | $245.47 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $204.17 / $323.59
| Professional | | $128.82 | $204.17 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $125.89 / $223.87
| Facility | | $125.89 | $125.89 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $213.80 / $354.81
| Facility | | $181.97 | $213.80 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $251.19 / $446.68
| Professional | | $151.36 | $251.19 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $2,570.40
| Facility | | $54.95 | $56.23 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $1,862.09 / $1,862.09
| Professional | | $1,621.81 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $257.04 / $630.96
| Facility | | $144.54 | $257.04 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $229.09 / $407.38
| Professional | | $141.25 | $229.09 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $190.55
| Professional | | $32.36 | $33.11 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $489.78 / $630.96
| Professional | | $5.01 | $489.78 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $245.47 / $436.52
| Facility | | $141.25 | $245.47 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $257.04 / $478.63
| Professional | | $151.36 | $257.04 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $2,187.76 / $4,365.16
| Facility | | $724.44 | $2,187.76 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $213.80 / $346.74
| Professional | | $134.90 | $213.80 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $223.87 / $251.19
| Professional | | $107.15 | $223.87 | $251.19 |