- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $1,202.26 / $6,606.93
| Facility | | $186.21 | $1,202.26 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $181.97 / $676.08
| Professional | | $77.62 | $181.97 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,570.40 / $2,951.21
| Facility | | $2,137.96 | $2,570.40 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $218.78 / $645.65
| Professional | | $89.13 | $218.78 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $141.25 / $2,511.89
| Professional | | $100.00 | $141.25 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $302.00 / $794.33
| Professional | | $91.20 | $302.00 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $416.87 / $1,122.02
| Professional | | $69.18 | $416.87 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,000.00 / $1,000.00
| Professional | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $331.13 / $724.44
| Facility | | $83.18 | $331.13 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $117.49 / $3,311.31
| Facility | | $81.28 | $117.49 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $616.60 / $3,311.31
| Professional | | $416.87 | $616.60 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,905.46 / $3,890.45
| Facility | | $1,047.13 | $1,905.46 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $275.42 / $831.76
| Professional | | $79.43 | $275.42 | $831.76 |