- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,258.93 / $17,782.79
| Facility | | $933.25 | $1,258.93 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $616.60 / $1,230.27
| Professional | | $426.58 | $616.60 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $630.96 / $1,288.25
| Facility | | $426.58 | $630.96 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $954.99 / $1,318.26
| Professional | | $660.69 | $954.99 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $467.74 / $562.34
| Facility | | $302.00 | $467.74 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $812.83 / $1,445.44
| Professional | | $478.63 | $812.83 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $660.69 / $1,202.26
| Facility | | $316.23 | $660.69 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $691.83 / $1,230.27
| Professional | | $354.81 | $691.83 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $316.23
| Professional | | $32.36 | $33.11 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $912.01 / $977.24
| Facility | | $588.84 | $912.01 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $660.69 / $691.83
| Facility | | $234.42 | $660.69 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $891.25 / $1,258.93
| Professional | | $676.08 | $891.25 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $660.69 / $1,288.25
| Facility | | $426.58 | $660.69 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $954.99 / $1,318.26
| Professional | | $660.69 | $954.99 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $851.14 / $1,949.84
| Facility | | $229.09 | $851.14 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $691.83 / $1,288.25
| Professional | | $537.03 | $691.83 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $630.96 / $1,000.00
| Professional | | $524.81 | $630.96 | $1,000.00 |