- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $3,467.37 / $15,135.61
| Facility | | $134.90 | $3,467.37 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $63.10 / $234.42
| Professional | | $28.84 | $63.10 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $79.43 / $138.04
| Professional | | $45.71 | $79.43 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,466.84 / $12,882.50
| Facility | | $2,511.89 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $67.61 / $138.04
| Professional | | $33.11 | $67.61 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $109.65 / $363.08
| Facility | | $74.13 | $109.65 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $69.18 / $147.91
| Professional | | $30.90 | $69.18 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $57.54 / $120.23
| Professional | | $28.84 | $57.54 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $75.86 / $138.04
| Professional | | $23.44 | $75.86 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $47.86 / $87.10
| Professional | | $22.39 | $47.86 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $1,288.25
| Facility | | $54.95 | $56.23 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $436.52
| Professional | | $436.52 | $436.52 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $63.10
| Professional | | $38.02 | $38.02 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $50.12 / $102.33
| Facility | | $26.30 | $50.12 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $57.54 / $112.20
| Professional | | $28.84 | $57.54 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $147.91
| Professional | | $85.11 | $85.11 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $131.83 / $208.93
| Professional | | $21.88 | $131.83 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $1,548.82 / $6,456.54
| Facility | | $489.78 | $1,548.82 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $46.77 / $112.20
| Professional | | $25.12 | $46.77 | $112.20 |