- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $3,801.89 / $8,511.38
| Facility | | $831.76 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,202.26 / $3,090.30
| Professional | | $323.59 | $1,202.26 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Professional | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $741.31 / $3,311.31
| Professional | | $323.59 | $741.31 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,884.03 / $4,073.80
| Professional | | $2,137.96 | $2,884.03 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $2,238.72 / $4,073.80
| Professional | | $363.08 | $2,238.72 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $426.58 / $467.74
| Professional | | $389.05 | $426.58 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $2,570.40 / $8,511.38
| Facility | | $724.44 | $2,570.40 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,513.56 / $3,981.07
| Professional | | $354.81 | $1,513.56 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $2,238.72 / $4,786.30
| Professional | | $436.52 | $2,238.72 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $354.81 / $1,698.24
| Facility | | $75.86 | $354.81 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $933.25 / $1,698.24
| Professional | | $302.00 | $933.25 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $630.96 / $4,466.84
| Facility | | $162.18 | $630.96 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,479.11 / $3,162.28
| Professional | | $323.59 | $1,479.11 | $3,162.28 |