- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $5,888.44 / $16,595.87
| Facility | | $1,584.89 | $5,888.44 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $177.83 / $501.19
| Professional | | $64.57 | $177.83 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $120.23 / $134.90
| Professional | | $120.23 | $120.23 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $4,466.84 / $12,022.64
| Facility | | $2,570.40 | $4,466.84 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $169.82 / $416.87
| Professional | | $74.13 | $169.82 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $162.18 / $363.08
| Facility | | $58.88 | $162.18 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $162.18 / $331.13
| Professional | | $77.62 | $162.18 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $251.19 / $758.58
| Facility | | $91.20 | $251.19 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $162.18 / $316.23
| Professional | | $70.79 | $162.18 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $131.83 / $229.09
| Professional | | $54.95 | $131.83 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $154.88 / $295.12
| Professional | | $48.98 | $154.88 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,258.93 / $1,258.93
| Professional | | $1,230.27 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $141.25 / $234.42
| Professional | | $141.25 | $141.25 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $138.04 / $269.15
| Facility | | $54.95 | $138.04 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $162.18 / $331.13
| Professional | | $69.18 | $162.18 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $245.47 / $602.56
| Professional | | $245.47 | $245.47 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $165.96 / $223.87
| Professional | | $50.12 | $165.96 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $389.05 / $501.19
| Facility | | $162.18 | $389.05 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $138.04 / $288.40
| Professional | | $60.26 | $138.04 | $288.40 |