- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $251.19 / $363.08
| Facility | | $199.53 | $251.19 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $181.97 / $338.84
| Professional | | $141.25 | $181.97 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $281.84 / $912.01
| Professional | | $162.18 | $281.84 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $549.54 / $870.96
| Facility | | $467.74 | $549.54 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $562.34 / $707.95
| Professional | | $234.42 | $562.34 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $371.54 / $13,182.57
| Facility | | $162.18 | $371.54 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $380.19 / $512.86
| Professional | | $316.23 | $380.19 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $323.59 / $2,041.74
| Facility | | $147.91 | $323.59 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $426.58 / $3,162.28
| Professional | | $204.17 | $426.58 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $234.42
| Professional | | $32.36 | $33.11 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $426.58
| Facility | | $257.04 | $257.04 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $389.05 / $630.96
| Professional | | $218.78 | $389.05 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $446.68 / $1,737.80
| Professional | | $234.42 | $446.68 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,584.89 / $1,584.89
| Facility | | $707.95 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $1,819.70 / $3,235.94
| Professional | | $251.19 | $1,819.70 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $436.52
| Professional | | $436.52 | $436.52 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $933.25 / $1,174.90
| Professional | | $363.08 | $933.25 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $4,365.16 / $10,964.78
| Facility | | $67.61 | $4,365.16 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $323.59 / $954.99
| Professional | | $181.97 | $323.59 | $954.99 |