- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $10,232.93 / $28,183.83
| Facility | | $100.00 | $10,232.93 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $72.44 / $114.82
| Professional | | $61.66 | $72.44 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,659.59 / $3,388.44
| Facility | | $1,174.90 | $1,659.59 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $144.54 / $245.47
| Professional | | $91.20 | $144.54 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $512.86 / $776.25
| Facility | | $512.86 | $512.86 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $138.04 / $234.42
| Professional | | $93.33 | $138.04 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $177.83 / $1,737.80
| Facility | | $100.00 | $177.83 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $165.96 / $851.14
| Professional | | $100.00 | $165.96 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $50.12 / $72.44
| Professional | | $44.67 | $50.12 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $151.36 / $151.36
| Facility | | $95.50 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $107.15 / $234.42
| Facility | | $104.71 | $107.15 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $158.49 / $223.87
| Professional | | $107.15 | $158.49 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,737.80 / $3,388.44
| Facility | | $1,148.15 | $1,737.80 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $144.54 / $199.53
| Professional | | $91.20 | $144.54 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $2,344.23 / $5,011.87
| Facility | | $645.65 | $2,344.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $102.33 / $204.17
| Professional | | $85.11 | $102.33 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $74.13 / $74.13
| Professional | | $74.13 | $74.13 | $74.13 |