- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $426.58 / $17,782.79
| Facility | | $58.88 | $426.58 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $128.82 / $524.81
| Professional | | $28.18 | $128.82 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $125.89
| Professional | | $107.15 | $107.15 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $794.33 / $1,621.81
| Facility | | $562.34 | $794.33 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $114.82 / $295.12
| Professional | | $46.77 | $114.82 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $501.19 / $870.96
| Facility | | $208.93 | $501.19 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $104.71 / $316.23
| Professional | | $37.15 | $104.71 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $138.04 / $302.00
| Facility | | $35.48 | $138.04 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $120.23 / $281.84
| Professional | | $35.48 | $120.23 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $223.87 / $239.88
| Facility | | $144.54 | $223.87 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $162.18 / $162.18
| Facility | | $158.49 | $162.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $158.49 / $281.84
| Professional | | $40.74 | $158.49 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $812.83 / $1,621.81
| Facility | | $549.54 | $812.83 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $114.82 / $288.40
| Professional | | $46.77 | $114.82 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $1,047.13 / $2,137.96
| Facility | | $281.84 | $1,047.13 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $109.65 / $281.84
| Professional | | $38.90 | $109.65 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $52.48 / $173.78
| Professional | | $27.54 | $52.48 | $173.78 |