- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $7,943.28 / $13,489.63
| Facility | | $134.90 | $7,943.28 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $138.04 / $354.81
| Professional | | $57.54 | $138.04 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $4,677.35 / $9,120.11
| Facility | | $3,548.13 | $4,677.35 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $128.82 / $269.15
| Professional | | $72.44 | $128.82 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $269.15 / $426.58
| Professional | | $128.82 | $269.15 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $208.93 / $3,019.95
| Facility | | $74.13 | $208.93 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $281.84 / $1,071.52
| Professional | | $177.83 | $281.84 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $309.03 / $398.11
| Professional | | $141.25 | $309.03 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $141.25 / $316.23
| Professional | | $141.25 | $141.25 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $125.89 / $398.11
| Professional | | $5.01 | $125.89 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $2,630.27 / $6,760.83
| Facility | | $1,905.46 | $2,630.27 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $165.96 / $346.74
| Professional | | $81.28 | $165.96 | $346.74 |