- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $3,890.45 / $6,025.60
| Facility | | $251.19 | $3,890.45 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $234.42 / $616.60
| Professional | | $117.49 | $234.42 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $346.74 / $912.01
| Professional | | $158.49 | $346.74 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $794.33 / $1,258.93
| Facility | | $676.08 | $794.33 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $416.87 / $954.99
| Professional | | $141.25 | $416.87 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $234.42 / $2,754.23
| Facility | | $100.00 | $234.42 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $389.05 / $676.08
| Professional | | $223.87 | $389.05 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $239.88 / $3,801.89
| Facility | | $100.00 | $239.88 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $489.78 / $1,862.09
| Professional | | $204.17 | $489.78 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $154.88
| Professional | | $32.36 | $33.11 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $3,890.45 / $4,570.88
| Facility | | $239.88 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $416.87 / $758.58
| Professional | | $269.15 | $416.87 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $436.52 / $912.01
| Professional | | $213.80 | $436.52 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $3,630.78 / $3,630.78
| Facility | | $204.17 | $3,630.78 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $537.03 / $1,778.28
| Professional | | $154.88 | $537.03 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $933.25
| Professional | | $436.52 | $436.52 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $660.69 / $1,258.93
| Professional | | $380.19 | $660.69 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,311.31 / $6,606.93
| Facility | | $2,884.03 | $3,311.31 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $257.04 / $831.76
| Professional | | $100.00 | $257.04 | $831.76 |