- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $4,677.35 / $14,125.38
| Facility | | $870.96 | $4,677.35 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $616.60 / $1,737.80
| Professional | | $251.19 | $616.60 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $323.59 / $691.83
| Professional | | $190.55 | $323.59 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $3,311.31 / $12,302.69
| Facility | | $831.76 | $3,311.31 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $645.65 / $870.96
| Professional | | $269.15 | $645.65 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $21,877.62 / $47,863.01
| Facility | | $1,584.89 | $21,877.62 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $43.65
| Facility | AS | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $602.56 / $1,348.96
| Professional | | $257.04 | $602.56 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $9,120.11 / $16,982.44
| Facility | | $4,466.84 | $9,120.11 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $575.44 / $776.25
| Professional | | $537.03 | $575.44 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $758.58
| Professional | | $32.36 | $33.11 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $7,762.47 / $13,182.57
| Facility | | $2,630.27 | $7,762.47 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $660.69 / $1,380.38
| Professional | | $251.19 | $660.69 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $436.52 / $812.83
| Professional | | $194.98 | $436.52 | $812.83 |