- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $1,737.80 / $17,782.79
| Facility | | $95.50 | $1,737.80 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $104.71 / $234.42
| Professional | | $42.66 | $104.71 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,862.09 / $3,715.35
| Facility | | $1,318.26 | $1,862.09 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $112.20 / $190.55
| Professional | | $64.57 | $112.20 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $467.74 / $562.34
| Facility | | $114.82 | $467.74 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $123.03 / $229.09
| Professional | | $67.61 | $123.03 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $147.91 / $316.23
| Facility | | $85.11 | $147.91 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $138.04 / $245.47
| Professional | | $83.18 | $138.04 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $46.77
| Professional | | $32.36 | $33.11 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $154.88 / $245.47
| Facility | | $120.23 | $154.88 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $109.65 / $109.65
| Facility | | $109.65 | $109.65 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $109.65 / $194.98
| Professional | | $60.26 | $109.65 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,905.46 / $3,715.35
| Facility | | $1,258.93 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $112.20 / $190.55
| Professional | | $64.57 | $112.20 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $2,238.72 / $4,570.88
| Facility | | $645.65 | $2,238.72 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $112.20 / $208.93
| Professional | | $60.26 | $112.20 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $79.43 / $109.65
| Professional | | $41.69 | $79.43 | $109.65 |