- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $3,019.95 / $7,943.28
| Facility | | $707.95 | $3,019.95 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $229.09 / $416.87
| Professional | | $114.82 | $229.09 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $190.55 / $457.09
| Professional | | $190.55 | $190.55 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,862.09 / $3,467.37
| Facility | | $891.25 | $1,862.09 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $204.17 / $363.08
| Professional | | $109.65 | $204.17 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $269.15 / $331.13
| Facility | | $60.26 | $269.15 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $169.82 / $263.03
| Professional | | $117.49 | $169.82 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $426.58 / $426.58
| Facility | | $104.71 | $426.58 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Facility | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $263.03 / $478.63
| Professional | | $138.04 | $263.03 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $851.14
| Facility | | $54.95 | $56.23 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,238.72 / $2,238.72
| Professional | | $1,949.84 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $288.40 / $2,454.71
| Facility | | $117.49 | $288.40 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $257.04 / $537.03
| Professional | | $120.23 | $257.04 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $229.09
| Professional | | $32.36 | $33.11 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $512.86 / $758.58
| Professional | | $380.19 | $512.86 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $257.04 / $501.19
| Facility | | $114.82 | $257.04 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $269.15 / $524.81
| Professional | | $138.04 | $269.15 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $1,445.44 / $3,548.13
| Facility | | $407.38 | $1,445.44 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $239.88 / $416.87
| Professional | | $120.23 | $239.88 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $269.15 / $316.23
| Professional | | $251.19 | $269.15 | $316.23 |