- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $3,981.07 / $6,606.93
| Facility | | $309.03 | $3,981.07 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $371.54 / $1,202.26
| Professional | | $204.17 | $371.54 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $602.56 / $1,348.96
| Professional | | $302.00 | $602.56 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $977.24 / $1,548.82
| Facility | | $831.76 | $977.24 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $501.19 / $831.76
| Professional | | $257.04 | $501.19 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $676.08 / $3,981.07
| Facility | | $245.47 | $676.08 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $660.69 / $933.25
| Professional | | $446.68 | $660.69 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $676.08 / $5,248.07
| Facility | | $251.19 | $676.08 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $537.03 / $1,819.70
| Professional | | $295.12 | $537.03 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $691.83
| Professional | | $32.36 | $33.11 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $3,890.45 / $4,570.88
| Facility | | $489.78 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $691.83 / $1,071.52
| Professional | | $346.74 | $691.83 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $724.44 / $1,096.48
| Professional | | $446.68 | $724.44 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,981.07 / $3,981.07
| Facility | | $2,754.23 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $446.68 / $2,290.87
| Professional | | $257.04 | $446.68 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $446.68 / $588.84
| Professional | | $446.68 | $446.68 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,047.13 / $1,348.96
| Professional | | $446.68 | $1,047.13 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,548.13 / $6,606.93
| Facility | | $2,884.03 | $3,548.13 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $436.52 / $1,479.11
| Professional | | $95.50 | $436.52 | $1,479.11 |