- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $2,818.38 / $8,317.64
| Facility | | $645.65 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $275.42 / $489.78
| Professional | | $173.78 | $275.42 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $117.49 / $117.49
| Professional | | $117.49 | $117.49 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $4,570.88 / $8,912.51
| Facility | | $2,454.71 | $4,570.88 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $245.47 / $467.74
| Professional | | $158.49 | $245.47 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $4,570.88 / $9,332.54
| Facility | | $223.87 | $4,570.88 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $269.15 / $309.03
| Facility | | $169.82 | $269.15 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $323.59 / $489.78
| Professional | | $208.93 | $323.59 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $7,413.10
| Facility | | $54.95 | $56.23 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $3,981.07 / $3,981.07
| Professional | | $3,981.07 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $380.19 / $4,265.80
| Facility | | $181.97 | $380.19 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $316.23 / $588.84
| Professional | | $177.83 | $316.23 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $245.47
| Professional | | $32.36 | $33.11 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $269.15 / $426.58
| Facility | | $169.82 | $269.15 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $323.59 / $501.19
| Professional | | $208.93 | $323.59 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $4,365.16 / $9,120.11
| Facility | | $1,659.59 | $4,365.16 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $275.42 / $426.58
| Professional | | $177.83 | $275.42 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $309.03 / $331.13
| Professional | | $309.03 | $309.03 | $331.13 |