- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $17,782.79 / $40,738.03
| Facility | | $194.98 | $17,782.79 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,882.50 / $20,417.38
| Facility | | $9,120.11 | $12,882.50 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $524.81 / $851.14
| Facility | | $457.09 | $524.81 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $31.62
| Facility | AS | $31.62 | $31.62 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $251.19 / $9,549.93
| Facility | | $177.83 | $251.19 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $275.42 / $6,165.95
| Facility | | $177.83 | $275.42 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $83.18 / $83.18 / $83.18
| Facility | AS | $83.18 | $83.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $263.03 / $371.54
| Facility | | $263.03 | $263.03 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $389.05 / $602.56
| Professional | | $213.80 | $389.05 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $457.09 / $1,148.15
| Facility | | $316.23 | $457.09 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $31.62 / $45.71 / $114.82
| Facility | AS | $31.62 | $45.71 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $660.69
| Professional | | $660.69 | $660.69 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $6,760.83 / $19,498.45
| Facility | | $2,290.87 | $6,760.83 | $19,498.45 |