- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $10,232.93 / $20,892.96
| Facility | | $501.19 | $10,232.93 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $338.84 / $724.44
| Professional | | $245.47 | $338.84 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $6,760.83 / $6,760.83
| Facility | | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $524.81 / $741.31
| Professional | | $371.54 | $524.81 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,071.52 / $1,230.27
| Facility | | $1,000.00 | $1,071.52 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $446.68 / $812.83
| Professional | | $275.42 | $446.68 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $407.38 / $676.08
| Facility | | $288.40 | $407.38 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $436.52 / $676.08
| Professional | | $288.40 | $436.52 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $524.81 / $549.54
| Facility | | $338.84 | $524.81 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $371.54 / $371.54
| Facility | | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $549.54 / $707.95
| Professional | | $371.54 | $549.54 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $5,370.32 / $6,760.83
| Facility | | $5,370.32 | $5,370.32 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $524.81 / $741.31
| Professional | | $371.54 | $524.81 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $549.54 / $5,754.40
| Facility | | $151.36 | $549.54 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $407.38 / $707.95
| Professional | | $281.84 | $407.38 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $269.15 / $478.63
| Professional | | $251.19 | $269.15 | $478.63 |