- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $3,235.94 / $8,317.64
| Facility | | $199.53 | $3,235.94 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $186.21 / $338.84
| Professional | | $147.91 | $186.21 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,570.40 / $2,951.21
| Facility | | $2,137.96 | $2,570.40 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $223.87 / $323.59
| Professional | | $169.82 | $223.87 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $660.69 / $933.25
| Professional | | $190.55 | $660.69 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $1,258.93 / $8,709.64
| Facility | | $114.82 | $1,258.93 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $229.09 / $371.54
| Professional | | $169.82 | $229.09 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $181.97 / $478.63
| Professional | | $151.36 | $181.97 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $346.74 / $416.87
| Professional | | $245.47 | $346.74 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $245.47 / $363.08
| Facility | | $162.18 | $245.47 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $245.47 / $1,659.59
| Facility | | $165.96 | $245.47 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $245.47 / $1,659.59
| Professional | | $165.96 | $245.47 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $1,047.13 / $2,344.23
| Facility | | $218.78 | $1,047.13 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $234.42 / $363.08
| Professional | | $147.91 | $234.42 | $363.08 |