- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $2,238.72 / $3,801.89
| Facility | | $295.12 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $288.40 / $489.78
| Professional | | $131.83 | $288.40 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $1,778.28 / $4,786.30
| Facility | | $56.23 | $1,778.28 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $331.13 / $912.01
| Professional | | $144.54 | $331.13 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $154.88 / $363.08
| Facility | | $154.88 | $154.88 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $602.56 / $602.56
| Professional | | $588.84 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $288.40 / $288.40
| Facility | | $288.40 | $288.40 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $316.23 / $758.58
| Professional | | $141.25 | $316.23 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $165.96 / $3,630.78
| Facility | | $117.49 | $165.96 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $407.38 / $524.81
| Professional | | $338.84 | $407.38 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,630.78 / $8,511.38
| Facility | | $1,737.80 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $323.59 / $758.58
| Professional | | $134.90 | $323.59 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $1,778.28 / $4,786.30
| Facility | | $56.23 | $1,778.28 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $331.13 / $912.01
| Professional | | $144.54 | $331.13 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $3,162.28 / $8,511.38
| Facility | | $1,258.93 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $316.23 / $794.33
| Professional | | $141.25 | $316.23 | $794.33 |