- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $3,715.35 / $12,022.64
| Facility | | $107.15 | $3,715.35 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $85.11 / $186.21
| Professional | | $52.48 | $85.11 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $67.61 / $208.93
| Facility | | $42.66 | $67.61 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $85.11 / $134.90
| Professional | | $53.70 | $85.11 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $74.13 / $74.13
| Professional | | $74.13 | $74.13 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $48.98
| Facility | | $48.98 | $48.98 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $67.61
| Facility | | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $102.33 / $169.82
| Professional | | $61.66 | $102.33 | $169.82 |
- 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
- $660.69 / $776.25 / $776.25
| Professional | | $660.69 | $776.25 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $107.15 / $2,951.21
| Facility | | $58.88 | $107.15 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $89.13 / $169.82
| Professional | | $56.23 | $89.13 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $173.78 / $239.88
| Professional | | $100.00 | $173.78 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $97.72 / $173.78
| Facility | | $54.95 | $97.72 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $102.33 / $165.96
| Professional | | $61.66 | $102.33 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $812.83 / $2,238.72
| Facility | | $162.18 | $812.83 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $81.28 / $134.90
| Professional | | $53.70 | $81.28 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $95.50 / $95.50
| Professional | | $89.13 | $95.50 | $95.50 |