- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $2,511.89 / $7,244.36
| Facility | | $331.13 | $2,511.89 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $162.18 / $512.86
| Professional | | $1.70 | $162.18 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $117.49 / $190.55
| Professional | | $117.49 | $117.49 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,137.96 / $208,929.61
| Facility | | $1,380.38 | $2,137.96 | $208,929.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $120.23
| Professional | | $67.61 | $67.61 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $295.12 / $346.74
| Professional | | $204.17 | $295.12 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $251.19 / $436.52
| Professional | | $141.25 | $251.19 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $467.74 / $489.78
| Professional | | $467.74 | $467.74 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $346.74 / $562.34
| Professional | | $165.96 | $346.74 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $3,630.78 / $6,165.95
| Facility | | $1,621.81 | $3,630.78 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $162.18
| Professional | | $162.18 | $162.18 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,698.24 / $25,118.86
| Facility | | $1,318.26 | $1,698.24 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $87.10
| Professional | | $67.61 | $67.61 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $1,288.25 / $6,606.93
| Facility | | $186.21 | $1,288.25 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $275.42 / $602.56
| Professional | | $134.90 | $275.42 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $478.63 / $676.08
| Professional | | $281.84 | $478.63 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $128.82 / $416.87
| Facility | | $38.90 | $128.82 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $128.82 / $407.38
| Professional | | $38.90 | $128.82 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $2,951.21 / $6,025.60
| Facility | | $1,000.00 | $2,951.21 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $229.09 / $436.52
| Professional | | $125.89 | $229.09 | $436.52 |