- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $1,412.54 / $12,302.69
| Facility | | $162.18 | $1,412.54 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $147.91 / $467.74
| Professional | | $85.11 | $147.91 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,162.28 / $6,456.54
| Facility | | $2,238.72 | $3,162.28 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $234.42 / $537.03
| Professional | | $138.04 | $234.42 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $562.34 / $1,819.70
| Facility | | $147.91 | $562.34 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $208.93 / $588.84
| Professional | | $102.33 | $208.93 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $213.80 / $1,047.13
| Facility | | $109.65 | $213.80 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $199.53 / $645.65
| Professional | | $102.33 | $199.53 | $645.65 |
- 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
- $165.96 / $275.42 / $489.78
| Facility | | $165.96 | $275.42 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $354.81 / $912.01
| Facility | | $346.74 | $354.81 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $346.74 / $630.96
| Professional | | $117.49 | $346.74 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,235.94 / $6,456.54
| Facility | | $2,187.76 | $3,235.94 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $245.47 / $537.03
| Professional | | $138.04 | $245.47 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $3,715.35 / $6,918.31
| Facility | | $812.83 | $3,715.35 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $173.78 / $346.74
| Professional | | $104.71 | $173.78 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $165.96 / $416.87
| Professional | | $87.10 | $165.96 | $416.87 |