- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $354.81 / $2,238.72
| Facility | | $181.97 | $354.81 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $151.36 / $204.17
| Professional | | $120.23 | $151.36 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $75.86 / $75.86
| Facility | | $66.07 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $223.87 / $371.54
| Professional | | $165.96 | $223.87 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $645.65 / $1,202.26
| Facility | | $77.62 | $645.65 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $263.03 / $457.09
| Professional | | $177.83 | $263.03 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $218.78 / $5,623.41
| Facility | | $190.55 | $218.78 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $218.78 / $398.11
| Professional | | $141.25 | $218.78 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $120.23 / $144.54
| Professional | | $120.23 | $120.23 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $190.55 / $489.78
| Professional | | $158.49 | $190.55 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,023.29 / $1,023.29
| Facility | | $1,023.29 | $1,023.29 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,348.96 / $1,348.96
| Professional | | $1,023.29 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $57.54
| Professional | | $32.36 | $33.11 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $199.53 / $302.00
| Facility | | $112.20 | $199.53 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $229.09 / $2,238,721.14
| Professional | | $144.54 | $229.09 | $2,238,721.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $223.87 / $295.12
| Professional | | $177.83 | $223.87 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $186.21 / $199.53
| Facility | | $186.21 | $186.21 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $177.83 / $398.11
| Professional | | $125.89 | $177.83 | $398.11 |