- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,174.90 / $11,748.98
| Facility | | $537.03 | $1,174.90 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $588.84 / $1,230.27
| Professional | | $416.87 | $588.84 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $218.78 / $436.52
| Professional | | $29.51 | $218.78 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,398.83 / $4,365.16
| Facility | | $1,479.11 | $2,398.83 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $457.09 / $660.69
| Professional | | $371.54 | $457.09 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $630.96 / $891.25
| Facility | | $457.09 | $630.96 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $630.96 / $776.25
| Professional | | $512.86 | $630.96 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $1,659.59
| Facility | | $851.14 | $851.14 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Facility | AS | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $741.31 / $2,754.23
| Professional | | $512.86 | $741.31 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $407.38
| Professional | | $32.36 | $33.11 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $3,388.44 / $6,025.60
| Facility | | $602.56 | $3,388.44 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $575.44 / $891.25
| Professional | | $416.87 | $575.44 | $891.25 |