- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $245.47 / $18,620.87
| Facility | | $63.10 | $245.47 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $93.33 / $457.09
| Professional | | $30.20 | $93.33 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $85.11 / $218.78
| Professional | | $27.54 | $85.11 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,023.29 / $2,137.96
| Facility | | $426.58 | $1,023.29 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $109.65 / $234.42
| Professional | | $45.71 | $109.65 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $107.15 / $288.40
| Professional | | $44.67 | $107.15 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $123.03 / $281.84
| Facility | | $52.48 | $123.03 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $95.50 / $257.04
| Professional | | $52.48 | $95.50 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $56.23
| Professional | | $32.36 | $33.11 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $186.21 / $204.17
| Facility | | $58.88 | $186.21 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $138.04 / $138.04
| Facility | | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $138.04 / $245.47
| Professional | | $45.71 | $138.04 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,071.52 / $2,137.96
| Facility | | $724.44 | $1,071.52 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $109.65 / $213.80
| Professional | | $45.71 | $109.65 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,380.38 / $2,754.23
| Facility | | $371.54 | $1,380.38 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $93.33 / $223.87
| Professional | | $41.69 | $93.33 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $56.23 / $141.25
| Professional | | $29.51 | $56.23 | $141.25 |