- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $288.40 / $3,981.07
| Facility | | $81.28 | $288.40 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $154.88 / $426.58
| Professional | | $70.79 | $154.88 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $4,570.88 / $7,079.46
| Facility | | $2,344.23 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $141.25 / $363.08
| Professional | | $95.50 | $141.25 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $446.68 / $707.95
| Facility | | $380.19 | $446.68 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $213.80 / $512.86
| Professional | | $93.33 | $213.80 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $288.40 / $3,801.89
| Facility | | $75.86 | $288.40 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $218.78 / $416.87
| Professional | | $147.91 | $218.78 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $2,570.40 / $5,754.40
| Facility | | $75.86 | $2,570.40 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $257.04 / $776.25
| Professional | | $144.54 | $257.04 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $190.55
| Professional | | $32.36 | $33.11 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $3,890.45 / $4,570.88
| Facility | | $141.25 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $295.12 / $467.74
| Professional | | $158.49 | $295.12 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $223.87 / $489.78
| Professional | | $120.23 | $223.87 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,737.80 / $1,737.80
| Facility | | $380.19 | $1,737.80 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $436.52 / $1,000.00
| Professional | | $102.33 | $436.52 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $354.81
| Professional | | $162.18 | $162.18 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $407.38 / $851.14
| Professional | | $144.54 | $407.38 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,548.13 / $6,606.93
| Facility | | $2,884.03 | $3,548.13 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $194.98 / $512.86
| Professional | | $77.62 | $194.98 | $512.86 |