- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $2,238.72 / $7,079.46
| Facility | | $457.09 | $2,238.72 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $467.74 / $891.25
| Professional | | $323.59 | $467.74 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $524.81 / $851.14
| Professional | | $346.74 | $524.81 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $380.19 / $3,311.31
| Professional | | $331.13 | $380.19 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,288.25 / $1,584.89
| Facility | | $457.09 | $1,288.25 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $457.09 / $794.33
| Professional | | $302.00 | $457.09 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $645.65 / $1,047.13
| Professional | | $489.78 | $645.65 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $416.87 / $645.65
| Professional | | $380.19 | $416.87 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $512.86 / $831.76
| Facility | | $338.84 | $512.86 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $346.74 / $630.96
| Professional | | $346.74 | $346.74 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $389.05 / $1,584.89
| Facility | | $302.00 | $389.05 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $537.03 / $1,995.26
| Professional | | $354.81 | $537.03 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $5,495.41 / $12,882.50
| Facility | | $1,348.96 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $426.58 / $741.31
| Professional | | $269.15 | $426.58 | $741.31 |