- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $2,238.72 / $3,801.89
| Facility | | $389.05 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $218.78 / $691.83
| Professional | | $67.61 | $218.78 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $3,019.95 / $9,332.54
| Facility | | $56.23 | $3,019.95 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $389.05 / $1,288.25
| Professional | | $74.13 | $389.05 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $186.21
| Facility | | $79.43 | $79.43 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $501.19 / $1,148.15
| Professional | | $79.43 | $501.19 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $245.47 / $954.99
| Professional | | $87.10 | $245.47 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $91.20 / $3,311.31
| Facility | | $63.10 | $91.20 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $588.84 / $912.01
| Professional | | $457.09 | $588.84 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $5,248.07 / $11,220.18
| Facility | | $2,398.83 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $407.38 / $1,023.29
| Professional | | $74.13 | $407.38 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $6,918.31 / $6,918.31
| Facility | | $1,659.59 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $109.65 / $109.65
| Professional | | $109.65 | $109.65 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $3,019.95 / $9,332.54
| Facility | | $56.23 | $3,019.95 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $389.05 / $1,288.25
| Professional | | $74.13 | $389.05 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $5,011.87 / $11,220.18
| Facility | | $1,659.59 | $5,011.87 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $389.05 / $1,023.29
| Professional | | $79.43 | $389.05 | $1,023.29 |