- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $3,630.78 / $8,511.38
| Facility | | $537.03 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $524.81 / $1,000.00
| Professional | | $346.74 | $524.81 | $1,000.00 |
- 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
- $371.54 / $562.34 / $891.25
| Professional | | $371.54 | $562.34 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $398.11 / $3,548.13
| Professional | | $338.84 | $398.11 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,412.54 / $1,778.28
| Facility | | $602.56 | $1,412.54 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $512.86 / $870.96
| Professional | | $346.74 | $512.86 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $691.83 / $1,148.15
| Professional | | $524.81 | $691.83 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $588.84 / $891.25
| Professional | | $537.03 | $588.84 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $575.44 / $933.25
| Facility | | $371.54 | $575.44 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $912.01
| Professional | | $501.19 | $501.19 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $426.58 / $1,698.24
| Facility | | $338.84 | $426.58 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $602.56 / $2,238.72
| Professional | | $478.63 | $602.56 | $2,238.72 |
- 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
- $309.03 / $489.78 / $831.76
| Professional | | $309.03 | $489.78 | $831.76 |