- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $2,818.38 / $10,715.19
| Facility | | $380.19 | $2,818.38 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $346.74 / $954.99
| Professional | | $208.93 | $346.74 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $239.88 / $257.04
| Professional | | $239.88 | $239.88 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $3,090.30 / $10,964.78
| Facility | | $954.99 | $3,090.30 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $407.38 / $630.96
| Professional | | $275.42 | $407.38 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $229.09 / $1,995.26
| Facility | | $208.93 | $229.09 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $229.09 / $263.03
| Professional | | $229.09 | $229.09 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $457.09 / $2,630.27
| Facility | | $371.54 | $457.09 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $363.08 / $691.83
| Professional | | $218.78 | $363.08 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $457.09 / $3,235.94
| Facility | | $371.54 | $457.09 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $346.74 / $676.08
| Professional | | $213.80 | $346.74 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $47.86
| Professional | | $32.36 | $33.11 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $3,890.45
| Facility | | $100.00 | $100.00 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $245.47 / $478.63
| Professional | | $208.93 | $245.47 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $5,248.07 / $9,120.11
| Facility | | $933.25 | $5,248.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $302.00 / $524.81
| Professional | | $186.21 | $302.00 | $524.81 |