- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $2,630.27 / $8,317.64
| Facility | | $93.33 | $2,630.27 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $173.78 / $281.84
| Professional | | $79.43 | $173.78 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,570.40 / $2,951.21
| Facility | | $2,137.96 | $2,570.40 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $173.78 / $316.23
| Professional | | $85.11 | $173.78 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $91.20 / $933.25
| Professional | | $79.43 | $91.20 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $147.91 / $524.81
| Facility | | $131.83 | $147.91 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $194.98 / $363.08
| Professional | | $87.10 | $194.98 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $234.42 / $489.78
| Professional | | $190.55 | $234.42 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $467.74 / $467.74
| Professional | | $275.42 | $467.74 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $181.97 / $338.84
| Facility | | $85.11 | $181.97 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $302.00
| Professional | | $162.18 | $162.18 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $104.71 / $870.96
| Facility | | $81.28 | $104.71 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $239.88 / $912.01
| Professional | | $190.55 | $239.88 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $2,511.89 / $5,248.07
| Facility | | $562.34 | $2,511.89 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $158.49 / $323.59
| Professional | | $77.62 | $158.49 | $323.59 |