- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $602.56 / $18,620.87
| Facility | | $295.12 | $602.56 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $288.40 / $724.44
| Professional | | $138.04 | $288.40 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,454.71 / $4,897.79
| Facility | | $1,737.80 | $2,454.71 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $426.58 / $691.83
| Professional | | $269.15 | $426.58 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $676.08 / $954.99
| Facility | | $302.00 | $676.08 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $354.81 / $794.33
| Professional | | $177.83 | $354.81 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $363.08 / $812.83
| Facility | | $162.18 | $363.08 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $316.23 / $676.08
| Professional | | $151.36 | $316.23 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $120.23
| Professional | | $32.36 | $33.11 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $575.44 / $630.96
| Facility | | $218.78 | $575.44 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $426.58 / $436.52
| Facility | | $363.08 | $426.58 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $426.58 / $794.33
| Professional | | $251.19 | $426.58 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,511.89 / $4,897.79
| Facility | | $1,698.24 | $2,511.89 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $436.52 / $691.83
| Professional | | $281.84 | $436.52 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $2,691.53 / $5,248.07
| Facility | | $549.54 | $2,691.53 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $309.03 / $616.60
| Professional | | $162.18 | $309.03 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $371.54 / $524.81
| Professional | | $223.87 | $371.54 | $524.81 |