- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $6,025.60 / $17,782.79
| Facility | | $537.03 | $6,025.60 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $346.74 / $776.25
| Professional | | $213.80 | $346.74 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,413.10 / $15,135.61
| Facility | | $5,370.32 | $7,413.10 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $588.84 / $812.83
| Professional | | $416.87 | $588.84 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $870.96 / $3,981.07
| Facility | | $501.19 | $870.96 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $446.68 / $977.24
| Professional | | $257.04 | $446.68 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $537.03 / $2,570.40
| Facility | | $263.03 | $537.03 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $467.74 / $954.99
| Professional | | $245.47 | $467.74 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $158.49
| Professional | | $32.36 | $33.11 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $630.96 / $676.08
| Facility | | $389.05 | $630.96 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $467.74 / $1,995.26
| Facility | | $457.09 | $467.74 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $676.08 / $1,000.00
| Professional | | $467.74 | $676.08 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,762.47 / $15,135.61
| Facility | | $5,370.32 | $7,762.47 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $630.96 / $831.76
| Professional | | $457.09 | $630.96 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $7,943.28 / $15,488.17
| Facility | | $1,318.26 | $7,943.28 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $407.38 / $776.25
| Professional | | $263.03 | $407.38 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $407.38 / $758.58
| Professional | | $354.81 | $407.38 | $758.58 |