- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,584.89 / $18,620.87
| Facility | | $363.08 | $1,584.89 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $467.74 / $1,122.02
| Professional | | $181.97 | $467.74 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,511.38 / $17,378.01
| Facility | | $6,165.95 | $8,511.38 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $537.03 / $1,380.38
| Professional | | $245.47 | $537.03 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,000.00 / $1,000.00
| Facility | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $562.34 / $1,698.24
| Professional | | $251.19 | $562.34 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $891.25 / $12,022.64
| Facility | | $316.23 | $891.25 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $575.44 / $1,479.11
| Professional | | $323.59 | $575.44 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $75.86
| Professional | | $32.36 | $33.11 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,122.02 / $1,202.26
| Facility | | $933.25 | $1,122.02 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $831.76 / $831.76
| Facility | | $794.33 | $831.76 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $794.33 / $1,412.54
| Professional | | $239.88 | $794.33 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $8,912.51 / $17,378.01
| Facility | | $5,888.44 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $537.03 / $1,348.96
| Professional | | $281.84 | $537.03 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $10,232.93 / $18,197.01
| Facility | | $2,884.03 | $10,232.93 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $575.44 / $1,380.38
| Professional | | $239.88 | $575.44 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $316.23 / $1,288.25
| Professional | | $181.97 | $316.23 | $1,288.25 |