- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $2,951.21 / $8,511.38
| Facility | | $151.36 | $2,951.21 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $151.36 / $371.54
| Professional | | $97.72 | $151.36 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,786.30 / $9,549.93
| Facility | | $2,630.27 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $144.54 / $354.81
| Professional | | $109.65 | $144.54 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $141.25 / $6,165.95
| Facility | | $141.25 | $141.25 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $141.25 / $208.93
| Professional | | $141.25 | $141.25 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $3,801.89 / $53,703.18
| Facility | | $34.67 | $3,801.89 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $234.42 / $524.81
| Professional | | $123.03 | $234.42 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $138.04 / $346.74
| Facility | | $102.33 | $138.04 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $213.80 / $316.23
| Professional | | $158.49 | $213.80 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $204.17 / $380.19
| Professional | | $123.03 | $204.17 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $50,118.72 / $75,857.76
| Facility | | $123.03 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $204.17 / $398.11
| Professional | | $169.82 | $204.17 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $3,467.37 / $7,244.36
| Facility | | $1,862.09 | $3,467.37 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $169.82 / $398.11
| Professional | | $89.13 | $169.82 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $134.90 / $346.74
| Facility | | $83.18 | $134.90 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $199.53 / $323.59
| Professional | | $123.03 | $199.53 | $323.59 |