- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $1,905.46 / $3,715.35
| Facility | | $104.71 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $138.04 / $630.96
| Professional | | $72.44 | $138.04 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $1,995.26 / $13,489.63
| Facility | | $263.03 | $1,995.26 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $158.49 / $346.74
| Professional | | $87.10 | $158.49 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $91.20 / $208.93
| Facility | | $91.20 | $91.20 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $263.03 / $407.38
| Professional | | $154.88 | $263.03 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $512.86 / $977.24
| Facility | | $199.53 | $512.86 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $173.78 / $316.23
| Professional | | $95.50 | $173.78 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $89.13 / $3,311.31
| Facility | | $43.65 | $89.13 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $134.90 / $194.98
| Professional | | $72.44 | $134.90 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,511.89 / $7,079.46
| Facility | | $1,288.25 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $151.36 / $309.03
| Professional | | $87.10 | $151.36 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,071.52 / $1,096.48
| Facility | | $1,047.13 | $1,071.52 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $120.23 / $245.47
| Professional | | $120.23 | $120.23 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $1,995.26 / $13,489.63
| Facility | | $263.03 | $1,995.26 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $158.49 / $346.74
| Professional | | $87.10 | $158.49 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $2,398.83 / $5,623.41
| Facility | | $954.99 | $2,398.83 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $165.96 / $316.23
| Professional | | $93.33 | $165.96 | $316.23 |