- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $1,737.80 / $17,782.79
| Facility | | $131.83 | $1,737.80 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $478.63 / $1,148.15
| Professional | | $64.57 | $478.63 | $1,148.15 |
- 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
- $104.71 / $660.69 / $1,479.11
| Professional | | $104.71 | $660.69 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $707.95 / $1,584.89
| Facility | | $112.20 | $707.95 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $354.81 / $1,737.80
| Professional | | $79.43 | $354.81 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $660.69 / $1,737.80
| Facility | | $83.18 | $660.69 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $549.54 / $1,548.82
| Professional | | $79.43 | $549.54 | $1,548.82 |
- 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
- $537.03 / $1,202.26 / $1,258.93
| Facility | | $537.03 | $1,202.26 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $870.96 / $954.99
| Facility | | $741.31 | $870.96 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $870.96 / $1,659.59
| Professional | | $91.20 | $870.96 | $1,659.59 |
- 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
- $104.71 / $660.69 / $1,479.11
| Professional | | $104.71 | $660.69 | $1,479.11 |
- 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
- $79.43 / $524.81 / $1,288.25
| Professional | | $79.43 | $524.81 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $128.82 / $1,023.29
| Professional | | $67.61 | $128.82 | $1,023.29 |