- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $2,818.38 / $18,620.87
| Facility | | $162.18 | $2,818.38 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $295.12 / $575.44
| Professional | | $81.28 | $295.12 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $676.08 / $1,348.96
| Facility | | $537.03 | $676.08 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $309.03 / $758.58
| Professional | | $134.90 | $309.03 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $501.19 / $954.99
| Facility | | $147.91 | $501.19 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $288.40 / $870.96
| Professional | | $100.00 | $288.40 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $281.84 / $831.76
| Facility | | $107.15 | $281.84 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $263.03 / $758.58
| Professional | | $102.33 | $263.03 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $54.95
| Professional | | $32.36 | $33.11 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $630.96 / $645.65
| Facility | | $380.19 | $630.96 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $457.09 / $478.63
| Facility | | $173.78 | $457.09 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $457.09 / $851.14
| Professional | | $120.23 | $457.09 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $691.83 / $1,348.96
| Facility | | $512.86 | $691.83 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $331.13 / $758.58
| Professional | | $134.90 | $331.13 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $776.25 / $1,737.80
| Facility | | $223.87 | $776.25 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $316.23 / $676.08
| Professional | | $102.33 | $316.23 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $169.82 / $549.54
| Professional | | $89.13 | $169.82 | $549.54 |