- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $1,819.70 / $4,168.69
| Facility | | $275.42 | $1,819.70 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $288.40 / $691.83
| Professional | | $134.90 | $288.40 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $3,981.07 / $19,498.45
| Facility | | $346.74 | $3,981.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $316.23 / $2,238.72
| Professional | | $144.54 | $316.23 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $380.19
| Facility | | $162.18 | $162.18 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $380.19 / $831.76
| Professional | | $194.98 | $380.19 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $501.19 / $3,090.30
| Facility | | $446.68 | $501.19 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $323.59 / $707.95
| Professional | | $154.88 | $323.59 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $194.98 / $3,311.31
| Facility | | $125.89 | $194.98 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $478.63 / $660.69
| Professional | | $338.84 | $478.63 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $354.81 / $870.96
| Professional | | $162.18 | $354.81 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $4,466.84 / $5,754.40
| Facility | | $1,659.59 | $4,466.84 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $269.15 / $436.52
| Professional | | $269.15 | $269.15 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $3,981.07 / $19,498.45
| Facility | | $346.74 | $3,981.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $316.23 / $2,238.72
| Professional | | $144.54 | $316.23 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $3,548.13 / $9,120.11
| Facility | | $524.81 | $3,548.13 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $331.13 / $870.96
| Professional | | $147.91 | $331.13 | $870.96 |