- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $6,456.54 / $10,000.00
| Facility | | $524.81 | $6,456.54 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $537.03 / $1,380.38
| Professional | | $354.81 | $537.03 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $776.25 / $1,862.09
| Professional | | $501.19 | $776.25 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,698.24 / $2,691.53
| Facility | | $1,445.44 | $1,698.24 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $1,202.26 / $2,454.71
| Professional | | $489.78 | $1,202.26 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $724.44 / $4,897.79
| Facility | | $389.05 | $724.44 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,047.13 / $1,479.11
| Professional | | $724.44 | $1,047.13 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $776.25 / $7,244.36
| Facility | | $389.05 | $776.25 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $1,096.48 / $3,981.07
| Professional | | $524.81 | $1,096.48 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $478.63
| Professional | | $32.36 | $33.11 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $5,754.40 / $7,762.47
| Facility | | $741.31 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,202.26 / $1,698.24
| Professional | | $676.08 | $1,202.26 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,202.26 / $1,819.70
| Professional | | $724.44 | $1,202.26 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,235.94 / $4,786.30
| Facility | | $1,737.80 | $3,235.94 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $478.63
| Facility | AS | $323.59 | $323.59 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $2,570.40 / $3,890.45
| Professional | | $630.96 | $2,570.40 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,230.27 / $1,737.80
| Professional | | $1,230.27 | $1,230.27 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $2,454.71 / $3,467.37
| Professional | | $851.14 | $2,454.71 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,413.10 / $9,120.11
| Facility | | $4,073.80 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $912.01 / $2,238.72
| Professional | | $89.13 | $912.01 | $2,238.72 |