- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $81.28 / $229.09
| Professional | | $39.81 | $81.28 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $35.48
| Professional | | $35.48 | $35.48 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $89.13
| Professional | | $85.11 | $85.11 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $81.28 / $245.47
| Professional | | $77.62 | $81.28 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $102.33 / $213.80
| Professional | | $47.86 | $102.33 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $123.03 / $154.88
| Professional | | $89.13 | $123.03 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $107.15 / $194.98
| Professional | | $74.13 | $107.15 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $95.50
| Professional | | $85.11 | $85.11 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,995.26 / $7,244.36
| Facility | | $537.03 | $1,995.26 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $81.28 / $208.93
| Professional | | $39.81 | $81.28 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $186.21 / $288.40
| Professional | | $30.20 | $186.21 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $95.50 / $162.18
| Facility | | $42.66 | $95.50 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $77.62 / $138.04
| Professional | | $32.36 | $77.62 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,584.89 / $3,890.45
| Facility | | $575.44 | $1,584.89 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $83.18 / $169.82
| Professional | | $42.66 | $83.18 | $169.82 |