- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $3,467.37 / $11,748.98
| Facility | | $812.83 | $3,467.37 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $457.09 / $933.25
| Professional | | $309.03 | $457.09 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $316.23 / $331.13
| Professional | | $151.36 | $316.23 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,630.78 / $7,413.10
| Facility | | $1,995.26 | $3,630.78 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $380.19 / $524.81
| Professional | | $309.03 | $380.19 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $295.12 / $309.03
| Facility | | $79.43 | $295.12 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $588.84 / $588.84
| Facility | | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $537.03 / $1,047.13
| Professional | | $331.13 | $537.03 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $45,708.82 / $45,708.82
| Facility | | $7,079.46 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $3,467.37
| Professional | | $3,090.30 | $3,090.30 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $794.33 / $4,365.16
| Facility | | $338.84 | $794.33 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $467.74 / $912.01
| Professional | | $316.23 | $467.74 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $316.23
| Professional | | $32.36 | $33.11 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $1,096.48 / $1,122.02
| Professional | | $416.87 | $1,096.48 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $602.56 / $1,000.00
| Facility | | $316.23 | $602.56 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $524.81 / $1,023.29
| Professional | | $331.13 | $524.81 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $3,630.78 / $7,244.36
| Facility | | $1,445.44 | $3,630.78 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $478.63 / $812.83
| Professional | | $288.40 | $478.63 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $302.00 / $316.23
| Professional | | $295.12 | $302.00 | $316.23 |