- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $3,235.94 / $7,244.36
| Facility | | $162.18 | $3,235.94 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $223.87 / $1,023.29
| Professional | | $91.20 | $223.87 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $389.05 / $1,096.48
| Professional | | $95.50 | $389.05 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $100.00 / $1,995.26
| Professional | | $89.13 | $100.00 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $489.78
| Facility | | $158.49 | $158.49 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $186.21 / $1,071.52
| Professional | | $95.50 | $186.21 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $851.14 / $1,258.93
| Professional | | $707.95 | $851.14 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $831.76 / $1,513.56
| Professional | | $141.25 | $831.76 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $389.05 / $1,122.02
| Facility | | $102.33 | $389.05 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $204.17
| Professional | | $85.11 | $85.11 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $120.23 / $794.33
| Facility | | $91.20 | $120.23 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $741.31 / $2,454.71
| Professional | | $537.03 | $741.31 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,884.03 / $5,754.40
| Facility | | $1,584.89 | $2,884.03 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $309.03 / $1,096.48
| Professional | | $87.10 | $309.03 | $1,096.48 |