- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $2,630.27 / $7,762.47
| Facility | | $275.42 | $2,630.27 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $229.09 / $549.54
| Professional | | $117.49 | $229.09 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $104.71 / $213.80
| Professional | | $104.71 | $104.71 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $190.55 / $223.87
| Professional | | $169.82 | $190.55 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $912.01 / $1,737.80
| Facility | | $204.17 | $912.01 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $208.93 / $389.05
| Professional | | $117.49 | $208.93 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $269.15 / $269.15
| Facility | | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $398.11 / $562.34
| Professional | | $295.12 | $398.11 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $977.24 / $1,122.02
| Facility | | $724.44 | $977.24 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $263.03 / $436.52
| Professional | | $112.20 | $263.03 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,884.03 / $6,760.83
| Facility | | $1,513.56 | $2,884.03 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $165.96 / $323.59
| Professional | | $144.54 | $165.96 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $1,513.56 / $6,165.95
| Facility | | $218.78 | $1,513.56 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $245.47 / $524.81
| Professional | | $120.23 | $245.47 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $128.82 / $128.82
| Facility | | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $416.87 / $575.44
| Professional | | $128.82 | $416.87 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $245.47 / $309.03
| Facility | | $117.49 | $245.47 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $245.47 / $309.03
| Professional | | $117.49 | $245.47 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $2,398.83 / $4,265.80
| Facility | | $602.56 | $2,398.83 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $190.55 / $354.81
| Professional | | $104.71 | $190.55 | $354.81 |