- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $524.81 / $17,782.79
| Facility | | $257.04 | $524.81 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $177.83 / $407.38
| Professional | | $125.89 | $177.83 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,479.11 / $2,951.21
| Facility | | $954.99 | $1,479.11 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $275.42 / $398.11
| Professional | | $213.80 | $275.42 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $501.19 / $776.25
| Facility | | $229.09 | $501.19 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $251.19 / $478.63
| Professional | | $141.25 | $251.19 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $288.40 / $524.81
| Facility | | $158.49 | $288.40 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $263.03 / $446.68
| Professional | | $147.91 | $263.03 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $89.13
| Professional | | $32.36 | $33.11 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $331.13 / $338.84
| Facility | | $234.42 | $331.13 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $234.42 / $389.05
| Facility | | $234.42 | $234.42 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $263.03 / $426.58
| Professional | | $186.21 | $263.03 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,513.56 / $2,951.21
| Facility | | $954.99 | $1,513.56 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $275.42 / $398.11
| Professional | | $213.80 | $275.42 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $1,659.59 / $3,235.94
| Facility | | $190.55 | $1,659.59 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $218.78 / $380.19
| Professional | | $147.91 | $218.78 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $190.55 / $275.42
| Professional | | $144.54 | $190.55 | $275.42 |