- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $100.00 / $416.87
| Facility | | $38.02 | $100.00 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $117.49 / $478.63
| Professional | | $41.69 | $117.49 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $162.18 / $416.87
| Professional | | $72.44 | $162.18 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $51.29 / $56.23
| Facility | | $42.66 | $51.29 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $112.20 / $138.04
| Professional | | $104.71 | $112.20 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $363.08 / $588.84
| Facility | | $316.23 | $363.08 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $120.23 / $309.03
| Professional | | $50.12 | $120.23 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $134.90 / $3,388.44
| Facility | | $44.67 | $134.90 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $154.88 / $338.84
| Professional | | $83.18 | $154.88 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $141.25 / $1,659.59
| Facility | | $44.67 | $141.25 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $199.53 / $467.74
| Professional | | $91.20 | $199.53 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $125.89
| Professional | | $32.36 | $33.11 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $891.25 / $2,344.23
| Facility | | $93.33 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $190.55 / $331.13
| Professional | | $95.50 | $190.55 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $134.90 / $371.54
| Professional | | $70.79 | $134.90 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $1,584.89 / $1,584.89
| Facility | | $316.23 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $128.82 / $812.83
| Professional | | $48.98 | $128.82 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $83.18 / $223.87
| Professional | | $83.18 | $83.18 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $208.93 / $501.19
| Professional | | $102.33 | $208.93 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,584.89 / $2,187.76
| Facility | | $977.24 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $107.15 / $407.38
| Professional | | $58.88 | $107.15 | $407.38 |