- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $562.34 / $17,782.79
| Facility | | $194.98 | $562.34 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $199.53 / $426.58
| Professional | | $93.33 | $199.53 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,398.83 / $4,897.79
| Facility | | $1,862.09 | $2,398.83 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $288.40 / $457.09
| Professional | | $154.88 | $288.40 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $501.19 / $954.99
| Facility | | $165.96 | $501.19 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $257.04 / $537.03
| Professional | | $117.49 | $257.04 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $251.19 / $630.96
| Facility | | $120.23 | $251.19 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $234.42 / $467.74
| Professional | | $117.49 | $234.42 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $61.66
| Professional | | $32.36 | $33.11 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $398.11 / $426.58
| Facility | | $288.40 | $398.11 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $288.40 / $288.40
| Facility | | $208.93 | $288.40 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $288.40 / $524.81
| Professional | | $131.83 | $288.40 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,511.89 / $4,897.79
| Facility | | $1,698.24 | $2,511.89 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $288.40 / $457.09
| Professional | | $154.88 | $288.40 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $2,818.38 / $5,370.32
| Facility | | $812.83 | $2,818.38 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $234.42 / $426.58
| Professional | | $120.23 | $234.42 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $165.96 / $316.23
| Professional | | $87.10 | $165.96 | $316.23 |