- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $3,090.30 / $9,549.93
| Facility | | $128.82 | $3,090.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $169.82 / $426.58
| Professional | | $77.62 | $169.82 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,786.30 / $9,772.37
| Facility | | $2,630.27 | $4,786.30 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $229.09 / $457.09
| Professional | | $190.55 | $229.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $1,258.93 / $4,073.80
| Facility | | $123.03 | $1,258.93 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $123.03 / $354.81
| Professional | | $123.03 | $123.03 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $1,318.26 / $53,703.18
| Facility | | $147.91 | $1,318.26 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $234.42 / $660.69
| Professional | | $87.10 | $234.42 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $199.53 / $363.08
| Facility | | $89.13 | $199.53 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $363.08 / $501.19
| Professional | | $239.88 | $363.08 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Facility | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $295.12 / $489.78
| Professional | | $158.49 | $295.12 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,235.94 / $5,248.07
| Facility | | $2,137.96 | $3,235.94 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $104.71 / $117.49
| Professional | | $87.10 | $104.71 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $50,118.72 / $75,857.76
| Facility | | $83.18 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $398.11 / $660.69
| Professional | | $288.40 | $398.11 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,019.95 / $5,754.40
| Facility | | $1,698.24 | $3,019.95 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $251.19 / $707.95
| Professional | | $83.18 | $251.19 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $104.71 / $380.19
| Facility | | $70.79 | $104.71 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $269.15 / $489.78
| Professional | | $158.49 | $269.15 | $489.78 |