- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $2,290.87 / $17,782.79
| Facility | | $177.83 | $2,290.87 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $147.91 / $371.54
| Professional | | $77.62 | $147.91 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,454.71 / $4,897.79
| Facility | | $1,445.44 | $2,454.71 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $199.53 / $338.84
| Professional | | $123.03 | $199.53 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $870.96 / $1,348.96
| Facility | | $707.95 | $870.96 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $190.55 / $363.08
| Professional | | $102.33 | $190.55 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $199.53 / $831.76
| Facility | | $102.33 | $199.53 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $190.55 / $436.52
| Professional | | $102.33 | $190.55 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $44.67
| Professional | | $32.36 | $33.11 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $257.04 / $295.12
| Facility | | $169.82 | $257.04 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $190.55 / $239.88
| Facility | | $186.21 | $190.55 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $186.21 / $331.13
| Professional | | $107.15 | $186.21 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,511.89 / $4,897.79
| Facility | | $1,659.59 | $2,511.89 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $194.98 / $338.84
| Professional | | $123.03 | $194.98 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $2,754.23 / $5,011.87
| Facility | | $812.83 | $2,754.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $186.21 / $331.13
| Professional | | $107.15 | $186.21 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $151.36 / $208.93
| Professional | | $79.43 | $151.36 | $208.93 |