- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $4,265.80 / $8,511.38
| Facility | | $69.18 | $4,265.80 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $18.20 / $42.66
| Professional | | $6.03 | $18.20 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $22.39 / $28.18
| Professional | | $17.78 | $22.39 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.99 / $42.66
| Professional | | $23.44 | $23.99 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $23.44 / $34.67 / $42.66
| Professional | 50 | $23.44 | $34.67 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Professional | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $36.31 / $39.81
| Professional | | $23.99 | $36.31 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $25.70 / $38.90
| Professional | | $12.02 | $25.70 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $22.39 / $22.39
| Professional | | $17.78 | $22.39 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $3,981.07 / $8,317.64
| Facility | | $588.84 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $16.60 / $36.31
| Professional | | $6.76 | $16.60 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $39.81 / $93.33
| Professional | | $26.30 | $39.81 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.59 / $27.54
| Facility | | $4.07 | $7.59 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $13.80 / $27.54
| Professional | | $5.50 | $13.80 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $436.52 / $3,890.45
| Facility | | $125.89 | $436.52 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $16.22 / $32.36
| Professional | | $7.08 | $16.22 | $32.36 |