- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $2,691.53 / $8,317.64
| Facility | | $691.83 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $275.42 / $1,071.52
| Professional | | $100.00 | $275.42 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $181.97 / $707.95
| Professional | | $81.28 | $181.97 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $645.65 / $1,023.29
| Professional | | $537.03 | $645.65 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $933.25 / $1,819.70
| Facility | | $169.82 | $933.25 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $316.23 / $1,071.52
| Professional | | $97.72 | $316.23 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Facility | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,071.52 / $1,548.82
| Professional | | $794.33 | $1,071.52 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $776.25 / $1,047.13
| Facility | | $660.69 | $776.25 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $724.44 / $1,202.26
| Professional | | $125.89 | $724.44 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,884.03 / $7,079.46
| Facility | | $1,071.52 | $2,884.03 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $169.82 / $194.98
| Professional | | $107.15 | $169.82 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,905.46 / $6,606.93
| Facility | | $588.84 | $1,905.46 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $416.87 / $1,122.02
| Professional | | $100.00 | $416.87 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $562.34 / $562.34
| Facility | | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,122.02 / $1,584.89
| Professional | | $562.34 | $1,122.02 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $616.60 / $645.65
| Facility | | $97.72 | $616.60 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $549.54 / $707.95
| Professional | | $45.71 | $549.54 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $2,398.83 / $4,265.80
| Facility | | $602.56 | $2,398.83 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $478.63 / $954.99
| Professional | | $93.33 | $478.63 | $954.99 |