- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $234.42 / $18,620.87
| Facility | | $87.10 | $234.42 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $97.72 / $316.23
| Professional | | $42.66 | $97.72 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $87.10 / $147.91
| Professional | | $87.10 | $87.10 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $676.08 / $1,318.26
| Facility | | $501.19 | $676.08 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $128.82 / $223.87
| Professional | | $69.18 | $128.82 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $147.91
| Facility | | $89.13 | $89.13 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $138.04 / $275.42
| Professional | | $74.13 | $138.04 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $134.90 / $275.42
| Facility | | $70.79 | $134.90 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $125.89 / $245.47
| Professional | | $74.13 | $125.89 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $186.21 / $190.55
| Facility | | $112.20 | $186.21 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $131.83 / $131.83
| Facility | | $131.83 | $131.83 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $131.83 / $239.88
| Professional | | $63.10 | $131.83 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $676.08 / $1,318.26
| Facility | | $501.19 | $676.08 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $125.89 / $223.87
| Professional | | $70.79 | $125.89 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $831.76 / $1,905.46
| Facility | | $218.78 | $831.76 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $123.03 / $234.42
| Professional | | $61.66 | $123.03 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $75.86 / $134.90
| Professional | | $39.81 | $75.86 | $134.90 |