- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $4,466.84 / $8,511.38
| Facility | | $169.82 | $4,466.84 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $371.54 / $954.99
| Professional | | $81.28 | $371.54 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $4,265.80 / $8,709.64
| Facility | | $2,754.23 | $4,265.80 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $251.19 / $870.96
| Professional | | $128.82 | $251.19 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $1,513.56
| Facility | | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $269.15 / $1,096.48
| Professional | | $117.49 | $269.15 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $691.83 / $5,495.41
| Facility | | $141.25 | $691.83 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $478.63 / $1,122.02
| Professional | | $147.91 | $478.63 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $51.29
| Professional | | $32.36 | $33.11 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $724.44 / $758.58
| Facility | | $165.96 | $724.44 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $537.03 / $537.03
| Facility | | $512.86 | $537.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $512.86 / $912.01
| Professional | | $112.20 | $512.86 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $4,466.84 / $8,709.64
| Facility | | $3,090.30 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $251.19 / $870.96
| Professional | | $128.82 | $251.19 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $5,011.87 / $8,912.51
| Facility | | $1,445.44 | $5,011.87 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $363.08 / $870.96
| Professional | | $112.20 | $363.08 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $144.54 / $831.76
| Professional | | $83.18 | $144.54 | $831.76 |