- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $2,454.71 / $7,943.28
| Facility | | $70.79 | $2,454.71 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $158.49 / $457.09
| Professional | | $63.10 | $158.49 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $81.28 / $123.03
| Professional | | $48.98 | $81.28 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $1,445.44 / $11,220.18
| Facility | | $239.88 | $1,445.44 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $251.19 / $323.59
| Professional | | $63.10 | $251.19 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $112.20 / $478.63
| Facility | | $112.20 | $112.20 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $186.21 / $467.74
| Professional | | $70.79 | $186.21 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,467.37 / $8,912.51
| Facility | | $2,344.23 | $3,467.37 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $208.93 / $354.81
| Professional | | $95.50 | $208.93 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $50.12 / $346.74
| Professional | | $32.36 | $50.12 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $2,137.96 / $5,011.87
| Facility | | $436.52 | $2,137.96 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $144.54 / $389.05
| Professional | | $61.66 | $144.54 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $173.78 / $316.23
| Professional | | $50.12 | $173.78 | $316.23 |