- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $5,888.44 / $16,595.87
| Facility | | $1,659.59 | $5,888.44 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $281.84 / $912.01
| Professional | | $102.33 | $281.84 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,466.84 / $12,882.50
| Facility | | $2,511.89 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $302.00 / $794.33
| Professional | | $138.04 | $302.00 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $3,162.28 / $6,606.93
| Facility | | $85.11 | $3,162.28 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $331.13 / $741.31
| Professional | | $125.89 | $331.13 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $263.03 / $309.03
| Facility | | $263.03 | $263.03 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $288.40 / $660.69
| Professional | | $114.82 | $288.40 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $281.84 / $489.78
| Professional | | $109.65 | $281.84 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $295.12 / $602.56
| Professional | | $100.00 | $295.12 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $19,498.45 / $19,498.45
| Facility | | $1,995.26 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,344.23 / $2,344.23
| Professional | | $2,187.76 | $2,344.23 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $234.42 / $389.05
| Professional | | $234.42 | $234.42 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $234.42 / $562.34
| Facility | | $97.72 | $234.42 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $281.84 / $630.96
| Professional | | $114.82 | $281.84 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $346.74 / $912.01
| Professional | | $346.74 | $346.74 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $346.74 / $457.09
| Professional | | $100.00 | $346.74 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,548.82 / $6,456.54
| Facility | | $575.44 | $1,548.82 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $245.47 / $588.84
| Professional | | $97.72 | $245.47 | $588.84 |