- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $4,466.84 / $9,772.37
| Facility | | $204.17 | $4,466.84 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $436.52 / $1,479.11
| Professional | | $190.55 | $436.52 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $281.84 / $302.00
| Professional | | $158.49 | $281.84 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $6,760.83 / $6,918.31
| Facility | | $6,760.83 | $6,760.83 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $407.38 / $562.34
| Professional | | $251.19 | $407.38 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $15,488.17
| Facility | | $602.56 | $602.56 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $302.00 / $537.03
| Professional | | $229.09 | $302.00 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $489.78
| Professional | | $380.19 | $380.19 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $281.84 / $467.74
| Facility | | $204.17 | $281.84 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $354.81 / $457.09
| Professional | | $275.42 | $354.81 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $812.83 / $2,089.30
| Facility | | $363.08 | $812.83 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $245.47 / $436.52
| Professional | | $177.83 | $245.47 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $4,677.35 / $5,011.87
| Facility | | $4,677.35 | $4,677.35 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $794.33 / $794.33 / $794.33
| Facility | 62 | $794.33 | $794.33 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $128.82 / $128.82 / $128.82
| Facility | AS | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $3,801.89
| Professional | | $3,801.89 | $3,801.89 | $3,801.89 |