- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $602.56 / $1,905.46
| Facility | | $199.53 | $602.56 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $245.47 / $707.95
| Professional | | $169.82 | $245.47 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $512.86 / $1,230.27
| Professional | | $199.53 | $512.86 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,659.59 / $2,691.53
| Facility | | $1,445.44 | $1,659.59 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $691.83 / $2,238.72
| Professional | | $208.93 | $691.83 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $478.63 / $3,548.13
| Facility | | $186.21 | $478.63 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $616.60 / $1,380.38
| Professional | | $323.59 | $616.60 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $501.19 / $4,897.79
| Facility | | $186.21 | $501.19 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $389.05 / $3,890.45
| Professional | | $194.98 | $389.05 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $3,890.45 / $4,570.88
| Facility | | $371.54 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $645.65 / $1,445.44
| Professional | | $407.38 | $645.65 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $707.95 / $1,862.09
| Professional | | $316.23 | $707.95 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $3,311.31 / $4,897.79
| Facility | | $316.23 | $3,311.31 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $1,023.29 / $3,715.35
| Professional | | $194.98 | $1,023.29 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $660.69
| Professional | | $660.69 | $660.69 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $812.83 / $2,691.53
| Professional | | $575.44 | $812.83 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,548.13 / $6,760.83
| Facility | | $2,754.23 | $3,548.13 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $288.40 / $812.83
| Professional | | $177.83 | $288.40 | $812.83 |