- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $1,445.44 / $11,481.54
| Facility | | $257.04 | $1,445.44 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $346.74 / $831.76
| Professional | | $229.09 | $346.74 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $13,182.57
| Facility | | $5,011.87 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $616.60 / $1,412.54
| Professional | | $323.59 | $616.60 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,000.00 / $1,621.81
| Facility | | $870.96 | $1,000.00 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $524.81 / $891.25
| Professional | | $288.40 | $524.81 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $724.44 / $3,981.07
| Facility | | $263.03 | $724.44 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $707.95 / $977.24
| Professional | | $489.78 | $707.95 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $676.08 / $7,762.47
| Facility | | $275.42 | $676.08 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $575.44 / $1,995.26
| Professional | | $323.59 | $575.44 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $776.25
| Professional | | $32.36 | $33.11 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $5,754.40 / $7,762.47
| Facility | | $537.03 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $776.25 / $1,202.26
| Professional | | $371.54 | $776.25 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $776.25 / $1,122.02
| Professional | | $478.63 | $776.25 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $6,760.83 / $6,760.83
| Facility | | $4,570.88 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $489.78 / $2,398.83
| Professional | | $281.84 | $489.78 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $616.60
| Professional | | $501.19 | $501.19 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,148.15 / $1,479.11
| Professional | | $501.19 | $1,148.15 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,585.78 / $9,120.11
| Facility | | $4,786.30 | $7,585.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $524.81 / $1,995.26
| Professional | | $95.50 | $524.81 | $1,995.26 |