- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $2,187.76 / $8,912.51
| Facility | | $186.21 | $2,187.76 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $181.97 / $1,862.09
| Professional | | $104.71 | $181.97 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $4,365.16 / $9,332.54
| Facility | | $1,071.52 | $4,365.16 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $524.81 / $562.34
| Facility | | $147.91 | $524.81 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $147.91 / $147.91
| Professional | | $147.91 | $147.91 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38,018.94 / $38,018.94 / $38,018.94
| Professional | | $38,018.94 | $38,018.94 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,187.76 / $2,187.76
| Professional | | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $295.12 / $1,230.27
| Facility | | $239.88 | $295.12 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $4,365.16 / $9,332.54
| Facility | | $1,071.52 | $4,365.16 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $144.54 / $398.11
| Facility | | $134.90 | $144.54 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $158.49 / $1,862.09
| Professional | | $114.82 | $158.49 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $501.19 / $602.56
| Professional | | $0.60 | $501.19 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $204.17 / $407.38
| Facility | | $154.88 | $204.17 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $154.88 / $407.38
| Professional | | $97.72 | $154.88 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,187.76 / $2,691.53
| Professional | | $2,041.74 | $2,187.76 | $2,691.53 |