- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $346.74 / $1,905.46
| Facility | | $199.53 | $346.74 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $354.81 / $812.83
| Professional | | $154.88 | $354.81 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $416.87 / $812.83
| Professional | | $208.93 | $416.87 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $588.84 / $588.84
| Professional | | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $794.33 / $1,258.93
| Facility | | $676.08 | $794.33 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $512.86 / $891.25
| Professional | | $208.93 | $512.86 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $501.19 / $6,918.31
| Facility | | $181.97 | $501.19 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $457.09 / $691.83
| Professional | | $354.81 | $457.09 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $501.19 / $7,762.47
| Facility | | $181.97 | $501.19 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $331.13 / $1,288.25
| Professional | | $199.53 | $331.13 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $234.42
| Professional | | $32.36 | $33.11 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $251.19 / $275.42
| Facility | | $251.19 | $251.19 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $436.52 / $724.44
| Professional | | $309.03 | $436.52 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $512.86 / $851.14
| Professional | | $288.40 | $512.86 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,288.25 / $1,288.25
| Facility | | $426.58 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $537.03 / $1,862.09
| Professional | | $295.12 | $537.03 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $316.23 / $478.63
| Professional | | $316.23 | $316.23 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $524.81 / $794.33
| Professional | | $281.84 | $524.81 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $4,786.30 / $19,498.45
| Facility | | $1,479.11 | $4,786.30 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $281.84 / $660.69
| Professional | | $144.54 | $281.84 | $660.69 |