- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $2,754.23 / $7,585.78
| Facility | | $676.08 | $2,754.23 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $288.40 / $660.69
| Professional | | $74.13 | $288.40 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $169.82 / $346.74
| Professional | | $35.48 | $169.82 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,000.00 / $2,137.96
| Facility | | $575.44 | $1,000.00 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $257.04 / $371.54
| Professional | | $67.61 | $257.04 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $758.58 / $1,584.89
| Facility | | $83.18 | $758.58 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $331.13
| Facility | | $70.79 | $70.79 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $204.17 / $707.95
| Professional | | $95.50 | $204.17 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $1,096.48
| Facility | | $54.95 | $56.23 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $2,951.21 / $2,951.21
| Professional | | $2,511.89 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $446.68 / $4,570.88
| Facility | | $74.13 | $446.68 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $302.00 / $645.65
| Professional | | $79.43 | $302.00 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $288.40
| Professional | | $32.36 | $33.11 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $269.15 / $512.86
| Facility | | $72.44 | $269.15 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $208.93 / $724.44
| Professional | | $95.50 | $208.93 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,479.11 / $3,630.78
| Facility | | $446.68 | $1,479.11 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $251.19 / $660.69
| Professional | | $75.86 | $251.19 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $331.13 / $346.74
| Professional | | $331.13 | $331.13 | $346.74 |