- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $426.58 / $3,090.30
| Facility | | $79.43 | $426.58 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $165.96 / $354.81
| Professional | | $69.18 | $165.96 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $269.15 / $794.33
| Professional | | $97.72 | $269.15 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $660.69 / $1,071.52
| Facility | | $575.44 | $660.69 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $263.03 / $891.25
| Professional | | $91.20 | $263.03 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $208.93 / $3,467.37
| Facility | | $72.44 | $208.93 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $288.40 / $549.54
| Professional | | $131.83 | $288.40 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $218.78 / $3,981.07
| Facility | | $72.44 | $218.78 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $389.05 / $1,548.82
| Professional | | $194.98 | $389.05 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $93.33
| Professional | | $32.36 | $33.11 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $3,890.45 / $4,570.88
| Facility | | $144.54 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $323.59 / $741.31
| Professional | | $162.18 | $323.59 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $316.23 / $812.83
| Professional | | $128.82 | $316.23 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $1,949.84 / $2,884.03
| Facility | | $123.03 | $1,949.84 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $331.13 / $1,479.11
| Professional | | $93.33 | $331.13 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $263.03 / $812.83
| Professional | | $263.03 | $263.03 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $398.11 / $1,071.52
| Professional | | $234.42 | $398.11 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,311.31 / $6,606.93
| Facility | | $2,398.83 | $3,311.31 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $251.19 / $602.56
| Professional | | $81.28 | $251.19 | $602.56 |