- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $380.19 / $1,905.46
| Facility | | $77.62 | $380.19 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $177.83 / $380.19
| Professional | | $77.62 | $177.83 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,584.89 / $1,584.89
| Facility | | $1,202.26 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $190.55 / $446.68
| Professional | | $109.65 | $190.55 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $588.84 / $933.25
| Facility | | $501.19 | $588.84 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $323.59 / $776.25
| Professional | | $117.49 | $323.59 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $204.17 / $3,162.28
| Facility | | $83.18 | $204.17 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $288.40 / $549.54
| Professional | | $162.18 | $288.40 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $213.80 / $1,513.56
| Facility | | $83.18 | $213.80 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $74.13 / $74.13 / $74.13
| Facility | 53 | $74.13 | $74.13 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $446.68 / $1,548.82
| Professional | | $213.80 | $446.68 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $112.20
| Professional | | $32.36 | $33.11 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $891.25 / $2,344.23
| Facility | | $169.82 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $389.05 / $831.76
| Professional | | $186.21 | $389.05 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $269.15 / $616.60
| Professional | | $134.90 | $269.15 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $2,951.21 / $2,951.21
| Facility | | $933.25 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $42.66 / $147.91 / $147.91
| Facility | 53 | $42.66 | $147.91 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $776.25 / $1,621.81
| Professional | | $151.36 | $776.25 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $691.83
| Professional | | $295.12 | $295.12 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $588.84 / $1,096.48
| Professional | | $316.23 | $588.84 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,584.89 / $2,187.76
| Facility | | $1,023.29 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $275.42 / $724.44
| Professional | | $100.00 | $275.42 | $724.44 |