- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $2,691.53 / $8,317.64
| Facility | | $660.69 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $131.83 / $251.19
| Professional | | $79.43 | $131.83 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $120.23 / $199.53
| Professional | | $120.23 | $120.23 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $144.54 / $275.42
| Professional | | $85.11 | $144.54 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $229.09 / $239.88
| Professional | | $229.09 | $229.09 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $186.21 / $295.12
| Professional | | $100.00 | $186.21 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,412.54 / $3,981.07
| Facility | | $467.74 | $1,412.54 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $173.78 / $173.78
| Professional | | $173.78 | $173.78 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,819.70 / $6,606.93
| Facility | | $537.03 | $1,819.70 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $138.04 / $316.23
| Professional | | $79.43 | $138.04 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $251.19 / $269.15
| Professional | | $194.98 | $251.19 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $131.83 / $309.03
| Facility | | $77.62 | $131.83 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $131.83 / $309.03
| Professional | | $75.86 | $131.83 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,548.82 / $3,890.45
| Facility | | $549.54 | $1,548.82 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $131.83 / $234.42
| Professional | | $79.43 | $131.83 | $234.42 |