- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $4,466.84 / $18,620.87
| Facility | | $190.55 | $4,466.84 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $117.49 / $295.12
| Professional | | $93.33 | $117.49 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,413.10 / $15,135.61
| Facility | | $5,370.32 | $7,413.10 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $199.53 / $263.03
| Professional | | $147.91 | $199.53 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $562.34 / $3,981.07
| Facility | | $177.83 | $562.34 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $177.83 / $331.13
| Professional | | $102.33 | $177.83 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $218.78 / $3,388.44
| Facility | | $112.20 | $218.78 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $186.21 / $1,778.28
| Professional | | $97.72 | $186.21 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $60.26
| Professional | | $32.36 | $33.11 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $199.53 / $208.93
| Facility | | $128.82 | $199.53 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $141.25 / $1,995.26
| Facility | | $138.04 | $141.25 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $199.53 / $302.00
| Professional | | $141.25 | $199.53 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $7,762.47 / $15,135.61
| Facility | | $5,128.61 | $7,762.47 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $199.53 / $257.04
| Professional | | $154.88 | $199.53 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $7,943.28 / $15,488.17
| Facility | | $1,548.82 | $7,943.28 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $147.91 / $263.03
| Professional | | $102.33 | $147.91 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $112.20 / $199.53
| Professional | | $97.72 | $112.20 | $199.53 |