- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $2,818.38 / $9,772.37
| Facility | | $245.47 | $2,818.38 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $741.31 / $2,137.96
| Professional | | $134.90 | $741.31 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $229.09 / $302.00
| Professional | | $204.17 | $229.09 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,398.83 / $4,897.79
| Facility | | $1,698.24 | $2,398.83 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $912.01 / $1,778.28
| Professional | | $213.80 | $912.01 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $630.96 / $1,445.44
| Facility | | $229.09 | $630.96 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $457.09 / $2,089.30
| Professional | | $165.96 | $457.09 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $831.76 / $2,187.76
| Facility | | $177.83 | $831.76 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $724.44 / $1,995.26
| Professional | | $169.82 | $724.44 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $83.18
| Professional | | $32.36 | $33.11 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,445.44 / $1,737.80
| Facility | | $1,000.00 | $1,445.44 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,047.13 / $1,096.48
| Facility | | $588.84 | $1,047.13 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $1,047.13 / $1,949.84
| Professional | | $181.97 | $1,047.13 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,511.89 / $4,897.79
| Facility | | $1,659.59 | $2,511.89 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $912.01 / $1,778.28
| Professional | | $213.80 | $912.01 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $2,818.38 / $5,370.32
| Facility | | $812.83 | $2,818.38 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $724.44 / $1,698.24
| Professional | | $169.82 | $724.44 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $234.42 / $1,071.52
| Professional | | $123.03 | $234.42 | $1,071.52 |