- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $3,548.13 / $7,762.47
| Facility | | $109.65 | $3,548.13 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $63.10 / $147.91
| Professional | | $41.69 | $63.10 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $60.26 / $79.43
| Professional | | $33.11 | $60.26 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,413.10 / $8,511.38
| Facility | | $4,786.30 | $7,413.10 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $83.18 / $117.49
| Professional | | $53.70 | $83.18 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $60.26 / $93.33
| Facility | | $52.48 | $60.26 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $58.88 / $100.00
| Professional | | $54.95 | $58.88 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $10,471.29 / $11,748.98
| Facility | | $7,244.36 | $10,471.29 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $81.28 / $134.90
| Professional | | $52.48 | $81.28 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $53.70 / $199.53
| Professional | | $45.71 | $53.70 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $8,317.64 / $21,379.62
| Facility | | $6,025.60 | $8,317.64 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $83.18 / $83.18
| Professional | | $83.18 | $83.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,348.96 / $3,235.94
| Facility | | $354.81 | $1,348.96 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $74.13 / $131.83
| Professional | | $46.77 | $74.13 | $131.83 |