- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $2,570.40 / $7,079.46
| Facility | | $199.53 | $2,570.40 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $169.82 / $263.03
| Professional | | $125.89 | $169.82 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,570.40 / $2,951.21
| Facility | | $2,137.96 | $2,570.40 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $199.53 / $309.03
| Professional | | $138.04 | $199.53 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $151.36 / $1,995.26
| Professional | | $128.82 | $151.36 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $302.00 / $363.08
| Facility | | $251.19 | $302.00 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $186.21 / $338.84
| Professional | | $131.83 | $186.21 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $218.78 / $446.68
| Professional | | $177.83 | $218.78 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $223.87 / $295.12
| Professional | | $190.55 | $223.87 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $199.53 / $316.23
| Facility | | $131.83 | $199.53 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $346.74
| Professional | | $85.11 | $85.11 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $158.49 / $575.44
| Facility | | $125.89 | $158.49 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $204.17 / $758.58
| Professional | | $162.18 | $204.17 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $812.83 / $2,344.23
| Facility | | $144.54 | $812.83 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $173.78 / $288.40
| Professional | | $114.82 | $173.78 | $288.40 |