- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $4,570.88 / $17,782.79
| Facility | | $478.63 | $4,570.88 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $549.54 / $4,466.84
| Professional | | $239.88 | $549.54 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,162.28 / $6,456.54
| Facility | | $2,290.87 | $3,162.28 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $776.25 / $5,623.41
| Professional | | $380.19 | $776.25 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $870.96 / $1,819.70
| Facility | | $407.38 | $870.96 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $676.08 / $6,606.93
| Professional | | $288.40 | $676.08 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $1,258.93 / $6,309.57
| Facility | | $316.23 | $1,258.93 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $1,174.90 / $6,309.57
| Professional | | $288.40 | $1,174.90 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $114.82
| Professional | | $32.36 | $33.11 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $4,365.16 / $5,370.32
| Facility | | $3,235.94 | $4,365.16 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $3,235.94 / $3,388.44
| Facility | | $741.31 | $3,235.94 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $3,235.94 / $5,888.44
| Professional | | $323.59 | $3,235.94 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,235.94 / $6,456.54
| Facility | | $2,238.72 | $3,235.94 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $794.33 / $5,754.40
| Professional | | $380.19 | $794.33 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $3,715.35 / $6,918.31
| Facility | | $870.96 | $3,715.35 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $660.69 / $5,370.32
| Professional | | $302.00 | $660.69 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $436.52 / $3,801.89
| Professional | | $229.09 | $436.52 | $3,801.89 |